Clinical Symptoms Of Urinary Tract Infection Research Articles

Revelation of Specific Ferocity Genes in Escherichia coli Isolated from Patient with Urinary Tract Infections (UTIs)

Background: The purpose of this research is to detect the occurrence of ferocity genes in uropathogenic E. coli that isolated from urinary tract infections by Polymerase chain reaction technique. Method: A whole of five strains of E.coli were obtained from patient with urinary tract infections. Identification of E.coli was depended on colonial morphology in culture media, gram stain, and conventional biochemical tests. ferocity factors genes (cnf-1, hly,urea A and ndv B) of E.coli strain were revelated by molecular technique. Results: ferocity genes were detected successfully by molecular technique in five isolates of E.coli, the predominance of genes in isolates are seen in percentage 100% Conclusion: Urinary tract infections still the major universal infection in the worldwide. The one of the most prevalent infectious diseases induce renal failure in patients is UTI that generated by UPEC. The presence of ferocity factors are critical features where the grade of pathogenicity of UPEC strains relied on it. This study indicate that was a real relationship between the ferocity factor genes of E.coli and clinical symptoms of UTI.

Urinary Tract Infections: The Current Scenario and Future Prospects.

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, occurring in both community and healthcare settings. Although the clinical symptoms of UTIs are heterogeneous and range from uncomplicated (uUTIs) to complicated (cUTIs), most UTIs are usually treated empirically. Bacteria are the main causative agents of these infections, although more rarely, other microorganisms, such as fungi and some viruses, have been reported to be responsible for UTIs. Uropathogenic Escherichia coli (UPEC) is the most common causative agent for both uUTIs and cUTIs, followed by other pathogenic microorganisms, such as Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus spp. In addition, the incidence of UTIs caused by multidrug resistance (MDR) is increasing, resulting in a significant increase in the spread of antibiotic resistance and the economic burden of these infections. Here, we discuss the various factors associated with UTIs, including the mechanisms of pathogenicity related to the bacteria that cause UTIs and the emergence of increasing resistance in UTI pathogens.

Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: A laboratory based cross-sectional study

Urogenital pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture. A cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results. The urogenital pathogens were detected using pathogen specific singleplex PCR. Data were cleaned and analyzed using STATA version 15. The median age of patients was 31[IQR 23 - 51] years and the majority (174, 76.7%) were females. Two thirds of patients had history of antibiotic use two weeks prior to recruitment (154, 67.8%). A total of 62(27.3%) urine samples were positive for at least one urogenital pathogen. Of 62 positive samples, 9 had two urogenital pathogens and 1 had three urogenital pathogens. The most predominant urogenital pathogen detected was Neisseria gonorrhoeae 25(34.2%) and Trichomonas vaginalis 24(32.9%). Being female (aOR 2.4; 95% CI: 1.04 - 5.49; p-value 0.039) and having history of using antibiotics in the past two weeks (aOR 1.9; 95%CI: 1.04 - 3.60; p-value 0.036) was independently associated with the presence of urogenital pathogens. More than a quarter of female patients with clinical symptoms of UTI and routine urine culture negative results were infected with urogenital pathogens mainly Neisseria gonorrhoeae and Trichomonas vaginalis. Further research with a larger sample set in a range of settings is required to understand the implications of these finding generally.

Pan-Resistome Characterization of Uropathogenic Escherichia coli and Klebsiella pneumoniae Strains Circulating in Uganda and Kenya, Isolated from 2017-2018.

Urinary tract infection (UTI) develops after a pathogen adheres to the inner lining of the urinary tract. Cases of UTIs are predominantly caused by several Gram-negative bacteria and account for high morbidity in the clinical and community settings. Of greater concern are the strains carrying antimicrobial resistance (AMR)-conferring genes. The gravity of a UTI is also determined by a spectrum of other virulence factors. This study represents a pilot project to investigate the burden of AMR among uropathogens in East Africa. We examined bacterial samples isolated in 2017–2018 from in- and out-patients in Kenya (KY) and Uganda (UG) that presented with clinical symptoms of UTI. We reconstructed the evolutionary history of the strains, investigated their population structure, and performed comparative analysis their pangenome contents. We found 55 Escherichia coli and 19 Klebsiella pneumoniae strains confirmed uropathogenic following screening for the prevalence of UTI virulence genes including fimH, iutA, feoA/B/C, mrkD, and foc. We identified 18 different sequence types in E. coli population while all K. pneumoniae strains belong to ST11. The most prevalent E. coli sequence types were ST131 (26%), ST335/1193 (10%), and ST10 (6%). Diverse plasmid types were observed in both collections such as Incompatibility (IncF/IncH/IncQ1/IncX4) and Col groups. Pangenome analysis of each set revealed a total of 2862 and 3464 genes comprised the core genome of E. coli and K. pneumoniae population, respectively. Among these are acquired AMR determinants including fluoroquinolone resistance-conferring genes aac(3)-Ib-cr and other significant genes: aad, tet, sul1, sul2, and cat, which are associated with aminoglycoside, tetracycline, sulfonamide, and chloramphenicol resistance, respectively. Accessory genomes of both species collections were detected several β-lactamase genes, blaCTX-M, blaTEM and blaOXA, or blaNDM. Overall, 93% are multi-drug resistant in the E. coli collection while 100% of the K. pneumoniae strains contained genes that are associated with resistance to three or more antibiotic classes. Our findings illustrate the abundant acquired resistome and virulome repertoire in uropathogenic E. coli and K. pneumoniae, which are mainly disseminated via clonal and horizontal transfer, circulating in the East African region. We further demonstrate here that routine genomic surveillance is necessary for high-resolution bacterial epidemiology of these important AMR pathogens.

URINARY TRACT INFECTION IN ADOLESCENTS. MODERN APPROACHES TO DIAGNOSTICS, TREATMENT AND DISPENSARY OBSERVATION

Current review provides data of etiology, pathogenesis and clinical evidences of urinary tract infection (UTI) in adolescents in connection with physiology of pubertal period. Data of congenital and acquired factors leading to origin and chronicity of the inflammation are presented. Treatment and rehabilitation approaches for adolescents with UTI are provided. Authors emphasize that metabolic disorders appeared in active stage of inflammation do not disappear when clinical symptoms of UTI, bacteriuria and leukocyturia are gone.

Detection of Antimicrobial Susceptibility and Integrons Among Extended-spectrum β-lactamase Producing Uropathogenic Escherichia coli Isolates in Southwestern Iran.

Urinary tract infections (UTIs) are one of the most prevalent infectious diseases and can lead to a high rate of morbidity and mortality. The emergence of multiple-drug resistant strains, particularly extended-spectrum beta-lactamases (ESBLs) producing strains, has become a global healthcare concern. Our study sought to investigate the antimicrobial resistance pattern and presence of integrons and fimH determinants among uropathogenic Escherichia coli (UPEC) isolates obtained from hospitalized Iranian patients. This cross-sectional study was performed on 121 E. coli isolates recovered from patients with clinical symptoms of UTIs, referred to Shiraz Nemazee Hospital, in 2016-17. The isolates were identified by standard microbiologic tests and confirmed by API 20E strip. Antimicrobial susceptibility testing was determined using the disk diffusion method. The presence of fimH and classes 1-3 integron encoding genes was determined using the polymerase chain reaction. Ampicillin (9.1%) and nalidixic acid (19.0%) showed the lowest level of antibiotic susceptibility. The highest level of susceptibility was toward imipenem (77.7%). The rate of ESBL-producing isolates was 42.1%. There was a significant association between production of ESBLs and higher antibiotic resistance in the tested isolates. Of the investigated virulence and resistance genes, fimH, intI1, and intI2 were positive in 98.3%, 59.5%, and 7.4% of isolates, respectively. The remarkable rate of ESBL-producing UPEC isolates accompanied with the presence of integrons suggest the necessity of restricted infection control policies to prevent further dissemination of resistant strains.

Bacterial Profile of Urinary Tract Infection and Antimicrobial Susceptibility Pattern Among Patients Attending at Bushra Medical Laboratory, Tripoli, Libya

BACKGROUND: Urinary tract infection (UTI) is a common infection that affects the urinary tract, particularly in women, children and elderly, and it doesn’t always cause classic signs and symptoms. Excessive utilization of antibiotics led to increased incidence of antibiotic resistance among uropathogens worldwide. AIM: To identify the causative bacteria of UTI and antimicrobial susceptibility pattern among patients attended to Bushra Medical laboratory, Tripoli, Libya. METHODS: This prospective study was conducted in Tripoli city, on 1423 urine specimens from untreated patients with clinical symptoms of UTIs. Bacterial identification and antimicrobial susceptibility testing were done on 291 specimens which their colony count ≥ 105 colony forming units (cfu)/mL, using DL-96II (Auto microbial identification and antimicrobial susceptibility testing system). RESULTS: The prevalence of significant bacteriuria was 20.4% (291/1423), among them 81.4% (237/291) were females and 18.6% (54/291) were males. Just 0.7% (2/291) cases of isolated bacteria were gram positive cocci represented in Staphylococcus aureus, that exhibited hugely resistance to Penicillin (100%) and susceptible to many tested antimicrobial agents, while 99.3% (289/291) were gram negative bacilli represented in Klebsiella pneumonia 43.6% (127/291); Escherichia coli 33% (96/291); Klebsiella ozaenae 10.7% (31/291); Proteus mirabilis 9.3% (27/291); Pseudomonas mendocina 1.7% (5/291) and Pseudomonas alcaligenes 1% (3/291). Considering the results of this study, Klebsiella pneumonia isolates were the predominant pathogens in UTI. Except for Pseudomonas isolates, our data demonstrated that gram negative isolates were susceptible to Cefoperazone/Sulbactam followed by Ceftazidime then Levofloxacin (3.9%, 4.9% and 6% resistance, respectively), while Pseudomonas isolates were extremely sensitive to Amikacin, Piperacillin and Norfloxacin. CONCLUSION: Because of highly resistant bacteria to antibiotics, physicians must prescribe appropriate antibiotics depending on antibiotics susceptibility results. Otherwise, routine monitoring of antimicrobial resistance among uropathogens must be accomplished to guide the treatment of UTIs in the country.

Антимікробна резистентність провідних збудників інфекцій сечових шляхів у Києві (Україна)

Мета роботи — вивчити резистентність до антибіотиків бактеріальних збудників інфекцій сечових шляхів (ІСШ), виділених у пацієнтів урологічного стаціонару в м. Києві.
 Матеріали і методи. Досліджено 1612 штамів бактерій, виділених із сечі хворих з ІСШ (цистит, уретрит, пієлонефрит), госпіталізованих в урологічне відділення ДУ «Інститут урології НАМН України» у м. Києві протягом 2016 р. Серед пацієнтів переважали жінки — 1201 (74,5 %). Вік хворих становив від 17 до 74 років. Для збору даних використано медичну документацію лікарні. Мікробіологічні дослідження виконано у лабораторії мікробіології ДУ «Інститут урології НАМН України». Аналізували результати культурального дослідження зразків сечі, зібраних за наявності клінічних ознак ІСШ. Дослідження клінічного матеріалу та інтерпретацію отриманих результатів проводили загальноприйнятими методами. Вивчено чутливість уропатогенів до 31 антибіотика дискодифузійним методом відповідно до рекомендацій Інституту клінічних та лабораторних стандартів США (Clinical and Laboratory Standards Institute (CLSI)).
 Результати та обговорення. Аналіз мікробного спектра сечі виявив домінування серед уропатогенів штамів Escherichia coli (32,0 %), Enterococcus faecalis (19,5 %), Klebsiella pneumoniae (10,9 %), Staphylococcus epidermidis (8,9 %), S. haemolyticus (6,5 %) та Pseudomonas aeruginosa (6,4 %). Частка Enterococcus faecium, Enterobacter aerogenes і Streptococcus viridans становила відповідно 2,5, 2,2 і 1,6 %, Enterobacter cloacae, Klebsiella oxytoca, Acinetobacter baumannii, Proteus vulgaris та Providencia rettgeri — менше 1,0 %. У більшості випадків (69,7 %) мікроорганізми виділено у монокультурі, у решті випадків — у мікробних асоціа- ціях. Високу резистентність до тестованих антибіотиків виявили штами E. aerogenes (45,1 %), E. cloacae (45,7 %), E. faecium (40,9 %), E. faecalis (40,7 %), E. coli (39,9 %), P. aeruginosa (34,0 %), K. pneumoniae (28,6 %). Найбільш активними до уропатогенів були іміпенем (E. coli — 87,6 %, P. aeruginosa — 75,7 %, E. cloacae — 67,3 %, E. aerogenes — 72,6 %, K. pneumoniae — 93,2 %), меропенем (E. coli — 89,1 %, P. aeruginosa — 76,7 %, K. pneumoniae — 82,6 %), лефлоцин (E. coli — 74,5 %, ентерококи — 78,7 %, P. aeruginosa — 76,7 %, E. cloacae — 73,9 %, E. aerogenes — 80,4 %, K. pneumoniae — 83,5 %), амоксицилін/клавуланат (ентерококи — 84,6 %), фурагін (ентерококи — 82,6 %), цефоперазон (K. pneumoniae — 89,2 %, P. aeruginosa — 73,8 %), цефтріаксон (K. pneumoniae — 80,1 %).
 Висновки. Антибіотикорезистентність збудників ІСШ — важлива терапевтична проблема. Найбільшою активністю до уропатогенів характеризуються іміпенем, меропенем, лефлоцин, амоксицилін/ клавуланат, фурагін, цефоперазон, цефтріаксон, які можна розглядати як препарат вибору для призначення стартової терапії ІСШ. Необхідно здійснювати постійний моніторинг за резистентністю до дії антибіотиків. Політику використання антибіотиків у кожному стаціонарі слід визначати залежно від локальних даних щодо резистентності до протимікробних препаратів.

Prevalence and antibiotic resistance pattern of bacteria isolated from urinary tract infections in Northern Iran.

Background:This study aimed to investigate the bacteria associated with urinary tract infection (UTI) and antibiotic susceptibility pattern of the isolates during 2013–2015 in Northern Iran.Materials and Methods:Overall 3798 patients with clinical symptoms of UTI were subjected as samples, and they were cultured and pure isolated bacteria were identified using biochemical tests and subjected to antibiogram assessment using disc diffusion method.Results:Totally, 568 (14.96%) from 3798 patients had positive UTI. Four hundred and ninety-seven (87.5%) from 568 isolated bacteria were resistant to at least one antibiotic. Escherichia coli, Staphylococcus spp., and Pseudomonas spp. were the most prevalent bacteria. Isolated bacteria indicated the highest antibiotic resistance to methicillin (76.06%) and ampicillin (89.29%) and also revealed the most sensitivity to imipenem (99.1%) and amikacin (91.57%). Statistical analysis of the resistance pattern trend during 3 years indicated the insignificant increase (P > 0.05) in antibiotic resistance of the isolates.Conclusion:The results of this study revealed a great concern for emerging UTI-related multidrug-resistant strains of bacteria causing UTI in Iran.

Antimicrobial Susceptibility Pattern and Age Dependent Etiology of Urinary Tract Infections in Nemazee Hospital, Shiraz, South-West of Iran

Background: Urinary tract infections (UTIs) are one of the most common bacterial diseases. The etiological agents and emergence of antimicrobial resistance UTIs vary according to time and geographical region. Objectives: The present study aimed to determine the prevalence of etiological agents of UTIs and determine their antimicrobial susceptibility pattern to locally available antibiotics. Patients and Methods: This descriptive cross-sectional study was conducted within six months on all patients with clinical symptoms of UTI who referred to Nemazee Teaching hospital, Shiraz, Iran. Clean catch midstream urine samples were collected and cultured on appropriate media in a short time as possible. Conventional bacteriological methods were followed for the isolation and identification of the bacteria. Antimicrobial susceptibility profiles were determined by locally available antibiotics by using disk diffusion method in accordance with CLSI recommendation. Results: In this study, from overall 9991 specimens analyzed 848 (8.5%) culture had significant bacterial growth. Of the total positive cultures, 500 (59%) cases were female. Escherichia coli (50.6%) was the predominant gram-negative isolated pathogen followed by Klebsiella spp. and Enterobacter spp., respectively. Enterococcus isolates (11.2%) was the most isolated gram-positive cocci. Nitrofurantoin (80.9%), gentamycin (77.9%) and amikacin (65.3%) had the most in-vitro antibacterial effect on E. coli isolates as the predominant cause of UTIs. Conclusions: The results of regional assessments, such as our study, provide not only useful information for prescription of more effective empirical therapy, but also good epidemiological background for comparison of our situation with other regions.

Isolation and Molecular Detection of Gram Negative Bacteria Causing Urinary Tract Infection in Patients Referred to Shahrekord Hospitals, Iran.

Background:Urinary Tract Infections (UTI), and their complications, cause serious health problems, which affect millions of people every year. Infections of the urinary tract are the second most common type of infection in the body and approximately 20% of women are especially prone to UTIs for reasons not yet well understood. Urinary Tract Infections in men are not as common as in women yet can be very serious when they do occur. Accurate identification of bacterial isolates is an essential task of the clinical microbiology laboratory.Objectives:The purpose of this study was to determine the incidence and variety of the causative microbial agents of UTIs in patients who had referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran.Patients and Methods:In this cross-sectional study 147 urine samples of patients (urine test results were positive for UTIs) were examined during April to September 2013. A total of 147 urine samples of patients with clinical symptoms of UTI who had been referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord (Iran), were collected and processed immediately for laboratory analysis.Results:Escherichia coli was identified as the most common causative agent of UTIs (51.70% of total isolates in both sexes), followed by Klebsiella pneumoniae (K. Pneumoniae) (16.32%). Frequency of Proteus spp., Acinetobacter spp., Entrobacter spp., Citrobacter spp., Pseudomonas aeruginosa (P. aeruginosa) and Providencia spp. was 10.88%, 6.12%, 5.44%, 4.08%, 3.40% and 2.04%, respectively. Statistical analysis by Fisher exact test showed that there was no significant relationship between the type of bacteria and gender (P > 0.05). Chi square test showed that there was no significant relationship between the type of bacteria and the use of catheter and age group (P > 0.05). However, there was a significant relationship between the type of bacteria and the history of hospitalization (P > 0.05).Conclusions:Our findings implied that a wide range of bacteria could be involved in creating urinary tract infection in patients referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran. Regardless of age, sex and the use of catheter, a wide range of bacteria could be involved in urinary tract infections.

Antimicrobial susceptibility profile of uropathogens in Maluti Adventist Hospital patients, 2011

BackgroundUrinary tract infections (UTIs) are amongst the most common infections encountered globally and are usually treated empirically based on bacterial resistance to antibiotics for a given region. Unfortunately in Lesotho, no published studies are available to guide doctors in the treatment of UTIs. Treatment protocols for Western countries have been adopted, which may not be applicable for this region.AimTo determine the antimicrobial susceptibility profile of uropathogens in outpatients at the Maluti Adventist Hospital.SettingThe study was conducted at the outpatient department of the Maluti Adventist Hospital in Mapoteng, Lesotho.MethodsThis was a prospective cross-sectional study using consecutive sampling of patients with clinical symptoms of UTI. Midstream urine samples were screened through chemistry and microscopy, then positive urine samples were cultured. The isolated uropathogens underwent antimicrobial susceptibility testing and inclusion continued until 200 culture samples were obtained. Descriptive statistics were used in the data analysis.ResultsThe top five cultured uropathogens were Escherichia coli (61.5%), Staphylococcus aureus (14%), Pseudomonas species (6.5%), Enterococcus faecalis (5.5%) and Streptococcus agalactiae (5%). The isolated uropathogens showed low sensitivity to cotrimoxazole (32.5% – 75.0%) and amoxicillin (33.2% – 87.5%) and high sensitivity to ciprofloxacin (84.0% – 95.1%) and nitrofurantoin (76.9% – 100%)ConclusionIn the Maluti setting, cotrimoxazole and amoxicillin should be avoided as first-line drugs for the empirical treatment of community-acquired UTI. We recommend the use of nitrofurantoin as first choice.

The Special Affinity of Particular Types of Proteus Mirabilis for the Urinary Tract

The strains of Proteus species found in significant numbers and as pure cultures in urine from 217 individuals were isolated, identified to species level and typed for proticine production (P type) and proticine sensitivity (S type) to give their P/S type. Urinary-tract infections with Proteus, principally P. mirabilis, were associated with the elderly. Ninety seven distinct P/S types were found but three P/S types P3/S1,8, P3/S1,8,13 and P3/S1,13 were isolated at a much higher frequency (14%) then could be explained from their faecal carriage rate. These types were almost without exception restricted to patients with clinical symptoms of urinary-tract infection and it is suggested therefore that they have some special affinity for the urinary tract.