Cause Of Urinary Tract Infections Research Articles

Bioinformatics analysis of clinical isolates of Escherichia coli from Nigeria and other countries for quinolone and fluoroquinolone resistance

Quinolones were the drugs of choice for the treatment of bacterial infections, especially, infections caused by Gram negative bacteria. Unfortunately, these drugs have been resisted by the microbial agents including Escherichia coli, known to be the leading cause of Urinary Tract Infection (UTI) globally. This study therefore was aimed at detecting all the genes involved in Quinolone resistance by the E. coli pathogen isolated from Nigeria and from other geographical regions, using robust techniques. Twenty-three sequence data files of Escherichia coli from various countries of the world were retrieved from the National Centre for biotechnology Information (NCBI) database and sent for genome assembly for processing of the short reads into long reads. The outcome was config. fasta files which were comprehensively annotated and characterized for genetic functions and mechanisms. A total of 208 antibiotic resistance genes were detected, out of which 27(13.0%) were linked to quinolone resistance and 14(6.7%) to multi- drug resistance. The result of this study significantly implicated many genes in quinolone resistance; notably were the efflux pump genes and their high percentage abundance. We recommend in-depth study of the genes for their expression capabilities, also the structure and features of the efflux pump genes to enable proper redesigning of drugs by integrating anti efflux pump substances that will selectively prevent the expression of the genes for antibiotic resistance, without any harm to the host, or that can destabilize the positive regulation of the operon for antibiotic resistance.

Product evaluation of the Luja Micro-hole Zone Technology in clean intermittent self-catheterisation

Clean intermittent self-catheterisation is a common procedure undertaken by people with bladder dysfunction. However, it is not without its complications, the main one being urinary tract infection. The most common causes of urinary tract infections are poor hygiene, technique and adherence, excessive post-void residual urine and bladder trauma. A catheter with new Micro-hole Zone Technology has been developed, which can potentially improve bladder emptying and minimise these complications. A case study is used to illustrate its effects in practice.

Antimicrobial resistance and ESBL production in uropathogenic Escherichia coli: a systematic review and meta-analysis in Ethiopia.

Antimicrobial resistance (AMR) is a serious threat to global health systems. Escherichia coli is a major cause of urinary tract infections (UTIs). Understanding the AMR patterns of uropathogenic E. coli (UPEC) is crucial for effective public health interventions worldwide. This systematic review and meta-analysis aimed to consolidate existing research and provide a comprehensive information on AMR UPEC in Ethiopia. We systematically searched databases such as PubMed, Web of Science, and Science Direct, along with including articles from Google Scholar. Data were extracted into Microsoft Excel and analysed using STATA 17.0. Cohen's kappa was computed to assess reviewer agreement, while the I2 statistic evaluated heterogeneity. Egger's tests were conducted to detect publication bias, and random-effects models were utilized to estimate the pooled resistance, with AMR rates for each antibiotic pooled separately. UPEC showed resistance rates, ranging from 3.64% (95% CI: -4.38% to 11.67%) for amikacin to 85.32% (95% CI: 78.6%-92.04%) for ampicillin. Highest resistance was to ampicillin (85.32%), followed by amoxicillin at 82.52% (95% CI: 74.3%-90.74%), tetracycline at 60.67% (95% CI: 51.53%-69.81%) and trimethoprim/sulfamethoxazole at 57.17% (95% CI: 49.93%-64.42%). Conversely, resistance rates were lower for amikacin at 3.64% and meropenem at 5.26% (95% CI: 2.64%-7.88%). UPEC demonstrated a pooled MDR rate of 79.17% (95% CI: 70.32%-88.01%) and a pooled ESBL production rate of 29.16% (95% CI: 22.36%-38.55%). High levels of AMR were observed in UPEC strains, highlighting a critical public health issue requiring urgent action through robust antimicrobial stewardship and surveillance to preserve effective UTI treatment options.

Prevalent Bacterial Etiologies of Urinary Tract Infections in Febrile Children Under Five Years of at Federal Medical Centre, Owerri, Imo State, Nigeria

Urinary Tract Infections (UTIs) in children under five years old pose a significant health concern, influenced by various factors like bacterial agents, anatomy, immunity, and genetics. The study aimed to identify prevalent bacterial causes of UTIs in febrile children under five at a medical center in Nigeria. Among 170 participants, E. coli was the most frequently isolated bacteria (37.5%), followed by Klebsiella spp (18.8%) and Staphylococcus aureus (15.6%). The research underscores E. coli as the primary uropathogen, aligning with global trends, while acknowledging local variations in UTI causative agents. Keywords: Urinary Tract Infections, Febrile Children, Bacterial Etiologies and Pediatric UTI.

Plant phenolics inhibit focal adhesion kinase and suppress host cell invasion by uropathogenic Escherichia coli.

Traditional folk treatments for the prevention and management of urinary tract infections (UTIs) and other infectious diseases often include plants and plant extracts that are rich in phenolic compounds. These have been ascribed a variety of activities, including inhibition of bacterial interactions with host cells. Here, we tested a panel of four well-studied phenolic compounds-caffeic acid phenethyl ester (CAPE), resveratrol, catechin, and epigallocatechin gallate-for the effects on host cell adherence and invasion by uropathogenic Escherichia coli (UPEC). These bacteria, which are the leading cause of UTIs, can bind and subsequently invade bladder epithelial cells via an actin-dependent process. Intracellular UPEC reservoirs within the bladder are often protected from antibiotics and host defenses and likely contribute to the development of chronic and recurrent infections. In cell culture-based assays, only resveratrol had a notable negative effect on UPEC adherence to bladder cells. However, both CAPE and resveratrol significantly inhibited UPEC entry into the host cells, coordinate with attenuated phosphorylation of the host actin regulator Focal Adhesion Kinase (FAK or PTK2) and marked increases in the numbers of focal adhesion structures. We further show that the intravesical delivery of resveratrol inhibits UPEC infiltration of the bladder mucosa in a murine UTI model and that resveratrol and CAPE can disrupt the ability of other invasive pathogens to enter host cells. Together, these results highlight the therapeutic potential of molecules like CAPE and resveratrol, which could be used to augment antibiotic treatments by restricting pathogen access to protective intracellular niches.IMPORTANCEUrinary tract infections (UTIs) are exceptionally common and increasingly difficult to treat due to the ongoing rise and spread of antibiotic-resistant pathogens. Furthermore, the primary cause of UTIs, uropathogenic Escherichia coli (UPEC), can avoid antibiotic exposure and many host defenses by invading the epithelial cells that line the bladder surface. Here, we identified two plant-derived phenolic compounds that disrupt activation of the host machinery needed for UPEC entry into bladder cells. One of these compounds, resveratrol, effectively inhibited UPEC invasion of the bladder mucosa in a mouse UTI model, and both phenolic compounds significantly reduced host cell entry by other invasive pathogens. These findings suggest that select phenolic compounds could be used to supplement existing antibacterial therapeutics by denying uropathogens shelter within host cells and tissues and help explain some of the benefits attributed to traditional plant-based medicines.

Antibiotic Profiling of E. coli Borne UTI Infection in Tertiary Healthcare Settings.

Introduction In general, with frequent recurrence of urinary tract infections (UTIs), long-term antibiotic therapy is stipulated at a low dose. With this type of situation and with easy access to several classes of antibiotics in tertiary health care settings, the use of such drugs results in the development of resistant bacteria in patients.Escherichia coliis a frequent cause of UTI observed. Hence, it was proposed in the present study to assess the antimicrobial resistance status ofE. coliin UTI-infected patients. Methods This study was conducted among female patients diagnosed with UTI.About 80 urine samples were collected in an aseptic condition, Under the process of culture identification 44 samples were found to be positive for UTI infection. The positive samples were plated on blood agar. Out of 44 samples, 18 samples were found to be positive, and 26 samples were negative for E. coli infection. The 18 samples were screened on MALDI-TOF for identification. Further, the samples were assessed for susceptibility to antibiotic medication within the study area. Result The study identified different strains ofE. coli,and the CHB geneE. coli wasfound in eight samples. The sample showed pink oval-round spots in the culture medium and was resistant to nitrofurantoin, cephalosporin, and cephalexin antibiotics. Hence, antimicrobial susceptibility tests arenecessaryfor managing and treating bacterialE. coliinfections. Conclusion E. coliis a common bacterium found in the vaginal region of patients, suggesting a potential infection.E. colican be associated with UTIs in women. The results from this study conclude thatE. coliis rapidly becoming multidrug-resistant, as only higher antibiotics can inhibit its growth. To effectively manage infections caused byE. coliproper diagnosis, laboratory testing, and antibiotic treatment are required.

Antibiotic Resistance of Uropathogenic Escherichia coli (UPEC) among Iranian Pediatrics: A Systematic Review and Meta-Analysis

Background: Uropathogenic Escherichia coli is a major cause of urinary tract infections (UTIs). This systematic review and meta-analysis was conducted to determine the prevalence of antibiotic-resistant uropathogenic E. coli among Iranian children with confirmed bacterial UTIs from 2012 to 2022.
 Methods: A systematic review was performed by searching PubMed, Scopus, Google Scholar, Web of Science, MagIran, Iranian Scientific Information Database, IranMedex, and Iranian Research Institute for Information Science and Technology. The antibiotic-specific pooled prevalence estimates were calculated by applying a random-effects model. Freeman-Tukey Double Arcsine transformation was applied. I-squared statistic, and Cochran’s Q test were computed and meta-regression was conducted on latitude of sampling location.
 Results: The literature search retrieved 2159 articles, among which 19 articles were included. The highest antibiotic resistance was related to doxycycline, ticarcillin-clavulanic acid, cefazolin, cefuroxime, and amoxycillin-clavulanic acid, 59%, 57%, 54%, 53%, and 52%, respectively. Meta-regression on the latitude was statistically significant for nitrofurantoin (P=0.05).
 Conclusion: Resistant uropathogenic Escherichia coli strains were observed in the majority of confirmed bacterial UTIs among Iranian children. The most effective antibiotics for uropathogens were colistin, meropenem, and imipenem.

Identification of complex III, NQR, and SDH as primary bioenergetic enzymes during the stationary phase of Pseudomonas aeruginosa cultured in urine-like conditions.

Pseudomonas aeruginosa is a common cause of urinary tract infections by strains that are often multidrug resistant, representing a major challenge to the world's health care system. This microorganism has a highly adaptable metabolism that allows it to colonize many environments, including the urinary tract. In this work, we have characterized the metabolic strategies used by stationary phase P. aeruginosa cells cultivated in urine-like media to understand the adaptations used by this microorganism to survive and produce disease. Our proteomics results show that cells rely on the Entner-Duodoroff pathway, pentose phosphate pathway, the Krebs cycle/ glyoxylate shunt and the aerobic oxidative phosphorylation to survive in urine-like media and other conditions. A deep characterization of the oxidative phosphorylation showed that the respiratory rate of stationary phase cells is increased 3-4 times compared to cells in the logarithmic phase of growth, indicating that the aerobic metabolism plays critical roles in the stationary phase of cells grown in urine like media. Moreover, the data show that respiratory complex III, succinate dehydrogenase and the NADH dehydrogenase NQR have important functions and could be used as targets to develop new antibiotics against this bacterium.

Combined functional genomic and metabolomic approaches identify new genes required for growth in human urine by multidrug-resistant Escherichia coli ST131.

Uropathogenic Escherichia coli (UPEC) cause ~80% of all urinary tract infections (UTIs), with increasing rates of antibiotic resistance presenting an urgent threat to effective treatment. To cause infection, UPEC must grow efficiently in human urine (HU), necessitating a need to understand mechanisms that promote its adaptation and survival in this nutrient-limited environment. Here, we used a combination of functional genomic and metabolomic techniques and identified roles for the metabolism of small peptides, amino acids, nucleotides, and L-lactate, as well as the stringent response pathway, lipopolysaccharide biosynthesis, and fluoride resistance, for UPEC growth in HU. We further demonstrated that pathways involving nucleotide metabolism and the stringent response are required for UPEC colonization of the mouse bladder. The UPEC genes and metabolic pathways identified in this study represent targets for the development of innovative therapeutics to prevent UPEC growth during human UTI, an urgent need given the rapidly rising rates of global antibiotic resistance.

Severe Bacterial Balanitis in Circumcised Adult Males

Balanitis is the inflammation of the glans penis while balanoposthitis involves both the glans penis and prepuce and occurs only in uncircumcised males. Balanitis is more common in uncircumcised males due to the occlusive effect of the foreskin, which facilitates smegma retention and bacterial and fungal overgrowth. Therefore, balanitis is rare after circumcision and severe balanitis is even rarer. In patients with recurrent balanoposthitis, circumcision is indicated, and the presence of diabetes should be ruled out. Diabetes mellitus is a frequent predisposing factor for Candida balanoposthitis and has been associated with male genital lichen sclerosus, which in progressive stages leads to phimosis. Circumcision is also indicated in the treatment of lichen sclerosus associated with phimosis. Candida albicans stands as the primary culprit in cases of acute infectious balanoposthitis, with aerobic bacteria constituting the second most common etiological factor. Among these bacteria, streptococci particularly groups B and D and staphylococci, notably S. aureus, are prevalent. Mixed infections may also occur. The typical clinical manifestations involve erythema and oedema accompanied by itching and/or pain. In instances of painful, erosive streptococcal balanoposthitis, severe balanopreputial oedema with purulent exudate can be observed. Staphylococcus haemolyticus, a prominent member of the coagulase-negative staphylococci of the skin microbiota, causes infections in the male urogenital tract, such as urinary tract infections, chronic prostatitis and epididymo-orchitis. However, it had not been associated with balanitis. Enterococcus faecalis is part of the normal gastrointestinal microflora and is also a frequent cause of urinary tract infections and of chronic prostatitis. Enterococcus has been associated with mild balanoposthitis in adults and E. faecalis has been described to cause balanoposthitis in young children, but its association with severe balanitis .....

Deep-learning-based diagnosis and grading of vesicoureteral reflux: A novel approach for improved clinical decision-making

Background/Aim: Vesicoureteral reflux (VUR) is a condition that causes urine to flow in reverse, from the bladder back into the ureters and occasionally into the kidneys. It becomes a vital cause of urinary tract infections. Conventionally, VUR’s severity is evaluated through imaging via voiding cystourethrography (VCUG). However, there is an unresolved debate regarding the precise timing and type of surgery required, making it crucial to classify VUR grades uniformly and accurately. This study’s primary purpose is to leverage machine learning, particularly convolutional neural network (CNN), to effectively identify and classify VUR in VCUG images. The aspiration is to diminish classification discrepancies between different observers and to create an accessible tool for healthcare practitioners. Methods: We utilized a dataset of 59 VCUG images with diagnosed VUR sourced from OpenI. These images were independently classified by two seasoned urologists according to the International Reflux Classification System. We utilized TensorFlow, Keras, and Jupyter Notebook for data preparation, segmentation, and model building. The CNN Inception V3 was employed for transfer learning, while data augmentation was used to improve the model’s resilience. Results: The deep-learning model attained exceptional accuracy rates of 95% and 100% in validation and training, respectively, after six cycles. It effectively categorized VUR grades corresponding to the global classification system. Matplotlib tracked loss and accuracy values, while Python-based statistical analysis assessed the model’s performance using the F1-score. Conclusion: The study’s model effectively categorized images, including those of vesicoureteral reflux, which has significant implications for treatment decisions. The application of this artificial intelligence model may help reduce interobserver bias. Additionally, it could offer an objective method for surgical planning and treatment outcomes.

DERMATITIS ARTEFACTA WITH Proteus mirabilis INFECTION IN COINCIDENCE WITH PYODERMA GANGRENOSUM IN SCHIZOPHRENIC PATIENT

Dermatitis artefacta (DA) is a psychiatric disorder with secondary manifestations on the skin. One of the most common skin lesions in DA is chronic ulcer which also can be caused by pyoderma gangrenosum (PG). There are some bacteria found in chronic ulcer such as Proteus mirabilis. A forty-one years old female with chronic wounds on her chest and left leg. Based on history taking of present illness, physical examinations, laboratory tests and histopathology of the skin lesions, the patient was diagnosed with DA and PG. She was also diagnosed with schizophrenia catatonic type. Chest x-ray showed pneumonia while the swab culture showed growth of Proteus mirbabilis. She was given an oral cefadroxile 500 mg three times daily, cetirizine 10 mg once daily, wound dressing and gentamycin ointment twice daily. She also received oral risperidone 0.5 mg twice daily combined with behavioral therapy from Psychiatric Outpatientclinic. Dermatitis artefacta is a psychocutaneous disorder with uncommon morphology. The most common psychological condition related to DA is schicophrenia. There are some specific histopathology features of DA such as dominant destruction of epidermal layer, multinucleated epidermal keratinocytes or destruction of keratinocytes. Chronic ulcers in DA might be mimicking with PG, which is a chronic recidive neutrophilic dermatoses. Proteus mirabilis is one of the most common causes of urinary tract infection, meanwhile it can also cause chronic ulcers and respiratory tract infection as pneumonia.

Molecular study of hpmA and ureR genes among Proteus mirabilis isolates inpatient with urinary tract infection

The most frequently occurring human bacterial infections are urinary tract infections (UTIs). P. mirabilis is one of the common causes of UTIs in humans with complicated UTIs, the formation of stones in the kidney, and long-term indwelling catheters. This study aims to isolate, and identify Proteusmirabilis from patients with UTIs using traditional methods and 16s rRNA gene sequencing techniques, as well as detect some virulence genes (hpm A and ureR) in Proteus mirabilis by using polymerase chain reaction (PCR). A total of five isolates of Proteus mirabilis were isolated from patients with urinary tract infections in June 2022. Identification of isolates depends on microscopic and cultural characteristics and traditional biochemical tests, finally, isolates are identified by target gene 16s rRNA using PCR technique, in addition, this study investigates the genes responsible for virulence factors such as hpmA and hpmR.In this study laboratory diagnosis and molecular analysis (16s rRNA gene) revealed that the five isolates are Proteus mirabilis also this study shows the presence of the hpmAgenes by PCR techniques in the isolates 100%. Our study has shown that 16s rRNA was a strong eclectic power and an excellent method for the identification of bacteria also these study frequency ofureR and hpmA in P.mirabilis isolated from UTIs and these genes have a manifest role in the infection.

A STUDY TO ASSESS THE KNOWLEDGE ON URINARY TRACT INFECTION REGARDING ITS PREVENTION AND MANAGEMENT AMONG THE 1ST YEAR B.SC NURSING AT SMT. NAGARATHNAMMA COLLEGE OF NURSING, BENGALURU

Good health is the fundamental right of every human being and it is essential to lead a successful life. The preamble to the WHO constitution also affirms that it is one of the fundamental rights of every human being is to enjoy The highest attainable standards of health. Moreover, emphasis is based on health promotion andpreventivehealthcare.Goodphysicalandmentalhealthofchildrenandadolescentsmakesforgoodhealth in adulthood. Agreeably, adolescence is a transitional period from dependent childhood to independent adulthood,thatis,agegroupfrom10-19years.Aboutone-fifthofIndiaspopulationisintheadolescenceage group and this is the earliest age where we can prevent morbidity in later life by means of health. According to 2022–2023-year statical data, the human body gets rid of liquid waste products through the urinary system, and so, it is important to protect this system from infections. Urinary tract infections are the secondmostcommonbacterialdiseasewhichaccountsformorethaneightmillionofficevisitsperyear.More than one lakh (1,00,000) people are hospitalized annually because of urinary tract infection and it is an importantcauseofmorbidityandmortalityinIndiansubjects.Youngageandfemalesexarethetwoimportant factors that contributes to the development of urinary tract infection and therefore it is the most common infection among adolescent girls, which distresses them, concerns their parents, and may cause permanent kidney damage, if there is any delay in treatment. According to the National Institute of Health and Clinical Excellence guidelines urinary tract infection is defined by a combination of clinical symptoms of urinary tract infection that usually include frequency, dysuria, pyuria, abdominal pain, back pain, fever, or urgency. Most urinary tract infections result from ascending infection by single gram-negative bacteria such as Escherichia coli, Klebsiella, Proteus, Enterobacter,orPseudomonas.Staphylococcalinfections,especiallyduetostaphylococcalsaprophyticus are common cause of urinary tract infection among adolescent girls. The two broad categories of urinary tract infectionarepyelonephritisorupperurinarytractinfectionandcystitisorlowerurinarytractinfection.Lower urinary tract infections are common among adolescent girls.

Screening and Characterization of Streptomyces spp. Isolated from Soil Producing a Potential Inhibitors of the Proteus mirabilis

Proteus mirabilis is a common cause of urinary tract infections and other nosocomial infections that can lead to severe health consequences. Despite the availability of various antibiotics, the increasing prevalence of multidrug-resistant (MDR) strains of Proteus mirabilis has necessitated the development of novel therapeutic compounds. The ability of species to produce a wide variety of secondary metabolites, such as antibiotics Streptomyces, immunosuppressants, and antivirals, is well known. In this study, a Streptomyces strain was isolated from soil near saltwater bodies, and its secondary metabolic extract was evaluated for its antimicrobial activity against Proteus mirabilis. The Streptomyces isolate demonstrated significant antimicrobial activity for Proteus mirabilis, with a minimum inhibitory concentration (MIC) of 34 µg/mL. The antimicrobial potential of the extract was confirmed through additional examination of the metabolite extract using deterministic assays, such as nucleic acid and protein release and time-kill curve assay. Molecular identification of the Streptomyces strain showed similarity with Streptomyces triticirhizae. GC-MS analysis of the extract revealed the presence of compounds such as Octadecanoic acid and n-Hexadecanoic acid, which are frequently associated with potent antimicrobial activity. HR-LCMS analysis revealed the presence of compounds such as Neomycin, Polymyxin B, and Maculosin, which also have potent antimicrobial activity. These findings strongly indicate the potential of the Streptomyces metabolite extracts as a novel therapeutic compound against Proteus mirabilis.

BlaCTX-M Mediated Extended Spectrum Beta-lactamase Production in Escherichia coli from Urine Samples

Objective: To assess the antimicrobial pattern of Escherichia coli isolates from urine samples, determine the proportion of multidrug resistant (MDR) and extended spectrum beta-lactamase (ESBL) and blaCTX-M gene of E. coli from the urine samples. Methods: A total of 2452 urine samples were collected and processed from April to October 2023 in clinically suspected urinary tract infection (UTI) patients attending B&B Hospital Pvt. Ltd to identify possible bacteria using standard microbiological procedures. E coli isolates were further subjected to antimicrobial susceptibility testing using Kirby Bauer disk diffusion method. Combination disk method was used to identify the ESBL phenotypes. Molecular detection of blaCTX-M gene was performed using conventional polymerase chain reaction. Results: A total of 338 (13.7%) samples showed significant bacterial growth. Maximum bacterial growth was found in outpatients (70.4%) and in patients above 60 years of age. Gram negative bacteria (87.8%) were predominant and E. coli (54.4%) was the most frequent. Nitrofurantoin, Aminoglycosides, Carbapenems and Polymixins were effective antibiotics. Among 184 E. coli isolates, 54 (29%) were MDR, 30 (16.3%) were ESBL producer. blaCTX-M gene was detected in 90% of the phenotypically confirmed ESBL producers. Conclusion: E. coli is the major cause of UTI and blaCTX-M is a prime contributor of ESBL production. High rate of resistance to third-generation Cephalosporins, Flouroquinolones and Cotrimoxazole make these antibiotics unsuitable for the treatment of UTI.

Predominance of multidrug-resistant bacteria causing urinary tract infections among symptomatic patients in East Africa: a call for action.

In low- and middle-income countries, antibiotics are often prescribed for patients with symptoms of urinary tract infections (UTIs) without microbiological confirmation. Inappropriate antibiotic use can contribute to antimicrobial resistance (AMR) and the selection of MDR bacteria. Data on antibiotic susceptibility of cultured bacteria are important in drafting empirical treatment guidelines and monitoring resistance trends, which can prevent the spread of AMR. In East Africa, antibiotic susceptibility data are sparse. To fill the gap, this study reports common microorganisms and their susceptibility patterns isolated from patients with UTI-like symptoms in Kenya, Tanzania and Uganda. Within each country, patients were recruited from three sites that were sociodemographically distinct and representative of different populations. UTI was defined by the presence of >104 cfu/mL of one or two uropathogens in mid-stream urine samples. Identification of microorganisms was done using biochemical methods. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion assay. MDR bacteria were defined as isolates resistant to at least one agent in three or more classes of antimicrobial agents. Microbiologically confirmed UTI was observed in 2653 (35.0%) of the 7583 patients studied. The predominant bacteria were Escherichia coli (37.0%), Staphylococcus spp. (26.3%), Klebsiella spp. (5.8%) and Enterococcus spp. (5.5%). E. coli contributed 982 of the isolates, with an MDR proportion of 52.2%. Staphylococcus spp. contributed 697 of the isolates, with an MDR rate of 60.3%. The overall proportion of MDR bacteria (n = 1153) was 50.9%. MDR bacteria are common causes of UTI in patients attending healthcare centres in East African countries, which emphasizes the need for investment in laboratory culture capacity and diagnostic algorithms to improve accuracy of diagnosis that will lead to appropriate antibiotic use to prevent and control AMR.

Exploring the Antimicrobial Potential of Cyperus rotundus Extract Against Multidrug-Resistant Escherichia coli in Urinary Tract Infections

The widespread use of antibiotics has contributed to the emergence of antibiotic-resistant bacteria, including Escherichia coli (E. coli), a primary cause of urinary tract infections (UTIs). The increasing antimicrobial resistance levels have prompted research into alternative treatments, such as medicinal plants, to counter this global health concern. This study aimed to evaluate the effectiveness of solvent extracts from Cyperus rotundus (C. rotundus) against multidrug-resistant strains of E. coli associated with UTIs, as well as examine the phytochemical characteristics of the plant extract. E. coli isolates from pregnant women with UTIs were collected from several clinical laboratories, and their antibiotic resistance levels were evaluated. The antimicrobial activity of the C. rotundus extract was assessed using the agar-well diffusion method. In addition, GC-MS analysis was employed to screen for qualitative phytochemicals and secondary metabolites. The C. rotundus extract demonstrated significant inhibitory results on the resistant isolates, with a zone of inhibition ranging from 9mm to 17mm. The extract was found to contain various phytochemicals such as alkaloids, flavonoids, phenolics, tannins, and triterpenoids. GC-MS analysis detected bioactive compounds such as 3, 4-Altrosan, Phytol, Isoquinoline, and beta-sitosterol. These findings show that C. rotundus has the potential to be a valuable resource in the fight against antibiotic-resistant UTIs, underscoring the need for further investigation.

Identification of potential inhibitors against Escherichia coli Mur D enzyme to combat rising drug resistance: an in-silico approach

Indiscriminate use of anti-microbial agents has resulted in the inception, frequency, and spread of antibiotic resistance among targeted bacterial pathogens and the commensal flora. Mur enzymes, playing a crucial role in cell-wall synthesis, are one of the most appropriate targets for developing novel inhibitors against antibiotic-resistant bacterial pathogens. In the present study, in-silico high-throughput virtual (HTVS) and Standard-Precision (SP) screening was carried out with 0.3 million compounds from several small-molecule libraries against the E. coli Mur D enzyme (PDB ID 2UUP). The docked complexes were further subjected to extra-precision (XP) docking calculations, and highest Glide-score compound was further subjected to molecular simulation studies. The top six virtual hits (S1–S6) displayed a glide score (G-score) within the range of −9.013 to −7.126 kcal/mol and compound S1 was found to have the highest stable interactions with the Mur D enzyme (2UUP) of E. coli. The stability of compound S1 with the Mur D (2UUP) complex was validated by a 100-ns molecular dynamics simulation. Binding free energy calculation by the MM-GBSA strategy of the S1-2UUP (Mur D) complex established van der Waals, hydrogen bonding, lipophilic, and Coulomb energy terms as significant favorable contributors for ligand binding. The final lead molecules were subjected to ADMET predictions to study their pharmacokinetic properties and displayed promising results, except for certain modifications required to improve QPlogHERG values. So, the compounds screened against the Mur D enzyme can be further studied as preparatory points for in-vivo studies to develop potential drugs. HIGHLIGHTS E.coli is a common cause of urinary tract infections. E.coli MurD enzyme is a suitable target for drug development. Novel inhibitors against E.coli MurD enzyme were identified. Molecular dynamics studies identified in-silico potential of identified compound. ADMET predictions and Lipinski’s rule of five studies showed promising results. Communicated by Ramaswamy H. Sarma

Raising the alarm: fosfomycin resistance associated with non-susceptible inner colonies imparts no fitness cost to the primary bacterial uropathogen.

While fosfomycin resistance is rare, the observation of non-susceptible subpopulations among clinical Escherichia coli isolates is a common phenomenon during antimicrobial susceptibility testing (AST) in American and European clinical labs. Previous evidence suggests that mutations eliciting this phenotype are of high biological cost to the pathogen during infection, leading to current recommendations of neglecting non-susceptible colonies during AST. Here, we report that the most common route to fosfomycin resistance, as well as novel routes described in this work, does not impair virulence in uropathogenic E. coli, the major cause of urinary tract infections, suggesting a re-evaluation of current susceptibility guidelines is warranted.