Growth Of Uropathogens Research Articles

Evaluation of uropathogens isolated in the outpatient department of a tertiary care hospital in south India

: Urinary tract infections constitute a large percentage of cases encountered in outpatient departments at tertiary care hospitals. These infections have been associated with a rise in antimicrobial resistance, leading to high morbidity and mortality. This rise in drug resistance has been linked to an increase in unauthorized, unregularized use of higher generations of antibiotics, leading to the prevalence of multi drug resistant organisms in the community.: The aim of this study is to analyze the prevalence of various uropathogens in the general population, along with their antibiotic susceptibility patterns. : The study has been carried out for a period of six months, during which a total of 872 urine samples were collected from the outpatient department at Kamineni Academy of Medical Sciences and Research Center, Hyderabad. Urine samples were subjected to bacterial culture and significant bacterial growth was identified using the colony count method. Identification and antimicrobial susceptibility testing was done using an automated VITEK 2 compact system. A total of 236 cases (27.1%) showed significant growth of uropathogens. The common organisms isolated were These organisms were seen more commonly in females. Multidrug resistance has been noted in multiple uropathogens, especially to fluoroquinolones and cephalosporins. This study documented an increase in antimicrobial resistance of the uropathogens isolated at the outpatient department. Judicious use of antibiotics may aid in prevention of spread of antimicrobial drug resistance in the general population.

Urinalysis Exhibits Excellent Predictive Capacity for the Absence of Urinary Tract Infection

ObjectiveTo assess predictive value of urinalysis for negative urine culture and absence of urinary tract infection, re-evaluate the microbial growth threshold for positive urine culture result, and describe antimicrobial resistance features. Urine culture is associated with 27% of U.S. hospitalizations, and unnecessary antibiotic prescription is a main antibiotic resistance contributor. MethodsUrinalyses with urine culture from women ages 18-49 from 2013 to 2020 were studied. Clinically diagnosed urinary tract infection (CUTI) was defined as (1) uropathogen growth, (2) documented diagnosis of urinary tract infection, and (3) antibiotic prescription. Sensitivity, specificity, and diagnostic predictive values were used to assess urinalysis performance in predicting isolation of a uropathogen by culture and in detection of CUTI. ResultsTotal 12,252 urinalyses were included. Forty-one percent of urinalyses were associated with positive urine culture and 1287 (10.5%) with CUTI. Negative urinalysis exhibited high predictive accuracy for negative urine culture (specificity 90.3%, PPV 87.3%) and absence of CUTI (specificity 92.2%, PPV 97.4%). Twenty-four percent of patients not meeting the CUTI definition were still prescribed antibiotics. Twenty-two percent of cultures associated with CUTI exhibited growth less than 100,000 CFU/mL. Escherichia coli was implemented as causing 70% of CUTIs, and 4.2% of these produced an extended spectrum beta-lactamase. ConclusionNegative urinalysis exhibits high predictive accuracy for absence of CUTI. A reporting threshold of 10,000 CFU/mL is more clinically appropriate than a 100,000 CFU/mL cutpoint. Reflex culture based on urinalysis results could complement clinical judgement and improve laboratory and antibiotic stewardship in premenopausal women.

Antibiotic sensitivity pattern of uropathogens among diabetic and non-diabetic pregnant women in Dhaka, Bangladesh

Objective: To determine the urinary tract infections (UTIs)-causing bacterial profile and antibiotic susceptibility pattern for the proper and complete treatment of UTIs in pregnant women with diabetes mellitus (DM). Methods: We collected 300 urine samples from diabetic and nondiabetic pregnant women at various gestational ages. After isolating and identifying uropathogens, we conducted an antibiotic sensitivity assay against fourteen commonly used antibiotics: amikacin, amoxicillin, ampicillin, azithromycin, cefixime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, co-trimoxazole, gentamicin, levofloxacin, netilmicin, nitrofurantoin. Results: Among the participants, 70% had DM but only 37.3% had positive uropathogen growth. Five gram-negative bacteria (Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., and Pseudomonas spp.) and 3 gram-positive bacteria (Streptococcus spp., Staphylococcus spp. and Enterococcus spp.) were indentified. Escherichia coli was the most prevalent bacteria (57.1%), followed by Klebsiella spp. (19.6%). In the antibiotic susceptibility assay, we found 96.5% of the isolated organisms were highly susceptible to levofloxacin, 94.2% to netilmicin, 88.2% to nitrofurantoin, 85.1% to amikacin, 79.8% to gentamicin, respectively. On the other hand, 64.8%, 63.6%, 61.8% of the isolates demonstrated high-level resistance to ampicillin, ceftazidime and amoxicillin whereas 38.0%, 37.1%, 33.6%, 30.9% and 30.0% of the organisms were resistant to co-trimoxazole, azithromycin, ciprofloxacin, cefuroxime, cefixime, respectivey. Conclusions: Our results suggest that amikacin, levofloxacin, netilmicin, nitrofurantoin, and gentamycin can be used as first-line treatments for UTIs, whether the patient has DM or not. Contrarily, amoxicillin, ampicillin, ceftazidime, azithromycin, and co-trimoxazole should be avoided in treating UTIs.

Diagnostic Accuracy of CHROMagar Orientation for Identification of Uropathogens

Objective: To determine the diagnostic accuracy of CHROMagar Orientation for its ability to support the growth and identification of uropathogens by keeping API 20E/20NE as a gold standard.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Jun to Nov 2019.
 Methodology: A total of 470 midstream specimen of urine from patients suspected of UTIs were analyzed. Urine specimens were inoculated by 1µL calibrated sterilized loop each on CLED Agar, Blood agar and CHROMagar Orientation media plates.Culture plates were incubated at 35.00±2.00ºC for 18 to 24 hours. As per standard protocols, isolates were identified by colony morphology, Gram stain, catalase, oxidase, DNAase, coagulase, and API 20E/20NE. In addition, the appearance of microorganism on CHROMagar Orientation media were identified according to the manufacturer’s instructions.
 Results: Out of 470 samples, 211 showed no growth, 90 were classified as mix growth (polymicrobial), and 169 samples were positive (unimicrobial) for the growth of uropathogens. All the samples positive for bacterial growth on conventional media were also positive on CHROMagar orientation and vice versa. The sensitivity and specificity of CHROMagar Orientation for differentiation of uropathogens were 99% and 100%, respectively.
 Conclusion: The overall findings of our study suggested that CHROMagar supports the growth of all uropathogens. It provided the rapid identification of organisms based on their colour morphology, even in a mixed bacterial culture, growth within 24 hours easily.

Studying the ability of lactobacillus bacteria to inhibit the growth of uropathogens and their adhesion to uroepithelial cells

تم الحصول على عشرين عينة مسحة مهبلية من المتزوجين الأصحاء النساء (مع الأطفال وبدونهم) ، خضعت جميع العينات للاختبار التقليدي الخصائص المورفولوجية والثقافية 12 عزلة موزعة من بين (Lactobacillus acidophilus (3) ، Lactobacillus casei (4)

Prevalence and Antimicrobial Resistance of Bacterial Uropathogens Isolated from Dogs and Cats.

Bacterial urinary tract infection (UTI) is a common diagnosis in companion animal practice and is one of the leading reasons for antimicrobial prescriptions. We analysed 1862 samples from the urinary tract of dogs and cats, submitted to a veterinary microbiological diagnostic laboratory in 2019 and 2020 in Germany. Susceptibility of 962 uropathogenic isolates to 15 antimicrobials, suggested as first- and second-line treatment options for UTI, was determined according to CLSI recommendations. Bacterial growth of uropathogens was detected in 43.9% of dog and in 38.5% of cat samples. Escherichia (E.) coli was the most frequently isolated pathogen (48.4%), followed by Enterococcus spp. (11.9%) and coagulase-positive staphylococci (CoPS; 11.5%). Females were more likely to exhibit a positive microbiological culture. Regarding first-line antibiotics, 93.4% of the most commonly isolated uropathogenic species were susceptible to the first-line antibiotics amoxicillin/clavulanic acid (AMC) and 87.6% to trimethoprim-sulfamethoxazole (SXT), while 76.1% showed decreased susceptibility to ampicillin (AMP). Multidrug resistance (MDR) was detected in 11.9% of E. coli, 50.4% of enterococci, and 42.7% of CoPS; 90.6% of these isolates were susceptible to nitrofurantoin (NIT). Our data indicate that empiric treatment of UTI with AMC or SXT could be recommended and is preferable to treatment with AMX. NIT should be considered for the treatment of MDR uropathogens.

Recurrent cystitis in women: principles of rational therapy

Introduction. Urinary tract infections (UTIs) are one of the most common disease among women.Aim. To determine the efficacy and tolerability of furazidin in the treatment of patients with exacerbation of chronic recurrent cystitis.Material and methods. a purpose was to determine the efficacy and tolerance of furazidin in the treatment of patients with chronic recurrent cystitis. In the study 56 female patients were enrolled, 28 of whom received ciprofloxacin (CG) and 28 – furazidin (FG). The patients received furazidin 100 mg three times a day for seven days (FG) or 500 mg of ciprofloxacin twice a day for seven days (CG). As well we analyzed the histories of 37 patients with bladder tuberculosis (TMP) stage 4in order to estimate the negative effect of non-optimal antibiotic therapy for UTI on the timely diagnosis of urogenital tuberculosis.Results. At the end of antibacterial therapy, dysuria persisted in one patient in the FG and in two in the CG. Urinalysis was normal in both groups in 96.4% of patients. The growth of uropathogens was in one case in each group. For 6 months, there were 5 recurrence episodes in the FG, and there were 11 relapses in the CG (p < 0.05). There were no side effects in the FG, but in the CG, adverse reactions developed in 9 patients (32.1%). Patients with TMP had annually from 4 to 7 exacerbations of cystitis, fluoroquinolones were prescribed to all; none investigations for M. tuberculosis were performed. Conclusion. Immediate results did not show statistically significant differences between the groups of patients treated with furazidin and ciprofloxacin, however, the tolerance of ciprofloxacin was lower (p >< 0.01). Long-term results have demonstrated a significant advantage of furazidin in the complex treatment of recurrent cystitis. All cases of stage 4 TMP are iatrogenic; an irreversible disabling complication was developed as a result of non-optimal therapy (primarily fluoroquinolones) for UTIs, which hided tuberculosis. >< 0.05). There were no side effects in the FG, but in the CG, adverse reactions developed in 9 patients (32.1%). Patients with TMP had annually from 4 to 7 exacerbations of cystitis, fluoroquinolones were prescribed to all; none investigations for M. tuberculosis were performed.Conclusion. Immediate results did not show statistically significant differences between the groups of patients treated with furazidin and ciprofloxacin, however, the tolerance of ciprofloxacin was lower (p < 0.01). Long-term results have demonstrated a significant advantage of furazidin in the complex treatment of recurrent cystitis. All cases of stage 4 TMP are iatrogenic; an irreversible disabling complication was developed as a result of non-optimal therapy (primarily fluoroquinolones) for UTIs, which hided tuberculosis.>< 0.01). Long-term results have demonstrated a significant advantage of furazidin in the complex treatment of recurrent cystitis. All cases of stage 4 TMP are iatrogenic; an irreversible disabling complication was developed as a result of non-optimal therapy (primarily fluoroquinolones) for UTIs, which hided tuberculosis.

Activity of Fosfomycin against the Spectrum of Uropathogens Causing Cystitis

Background: Urinary tract infections (UTIs) are the most frequent bacterial infections commonly seen in females. A high degree of antimicrobial resistance in uropathogens has challenged the use of therapeutic agents. Fosfomycin, which is an old antibiotic with distinctive characteristics, seems to be a promising novel therapeutic agent with a good bactericidal activity towards multi-drug resistant (MDR) uropathogens. Objective: The main objective of the study is to evaluate the antibacterial activity of fosfomycin among uropathogens causing cystitis. Methods: The study was carried out between 2017-2018. A total of 2060 UTI suspects from outpatient departments (OPDs) and inpatient departments (IPDs) were screened. Out of 2060 screened patients, 1658 were IPD patients, and 402 were OPD patients. The patient’s midstream urine samples were collected aseptically and processed according to standard protocols. The frequency of extendedspectrum- beta lactamases (ESBLs) producer and carbapenem resistance were estimated, respectively. Cultures with significant growth of uropathogens were identified, and minimum inhibitory concentration (MIC) to fosfomycin was determined by agar dilution (AD) and by E-test methods. Results: 184 out of 2060 (8.9%) urine samples showed significant growth of uropathogens. Uropathogenic Escherichia coli (UPEC) (64%, 118/184) was found to be the most isolated uropathogen. Among these Gram-negative uropathogens, 80% were ESBLs producers, 43.2% were carbapenemresistant, and 78% isolates were found to be MDR. The fosfomycin susceptibility for UPEC was 95% by the AD method. Conclusions: This study suggests that fosfomycin is reasonably effective and can be used in the treatment of MDR uropathogens along with uncomplicated UTIs.

OCCURRENCE AND ANTIBACTERIAL SUSCEPTIBILITY PATTERN OF UROPATHOGENS AMONG STUDENTS OF MODIBBO ADAMA UNIVERSITY OF TECHNOLOGY, YOLA

In order to assess the occurrence and antimicrobial profile of urinary tract pathogens, 80 early morning mid-stream urine samples were collected from students of Modibbo Adama University of Technology Yola, and cultured on Cysteine Lactose electrolyte deficient medium using standard microbiological methods. A total 43 urine samples representing an occurrence of 65% yielded significant growth of uropathogens. It was observed that females were more infected than the males with an occurrence rate of 40 % and 25 % respectively. Common uropathogens isolated in this study include: Staphylococcus aureus (26.1%), E coli (23.1%), Klebsiella spp (17.3%), Pseudomonas aeruginosa (11.5%), Enterococcus spp (9.6%),, Proteus spp (7.6%) and Staphylococcus saprophyticcus (5.8%). The highest occurrence of the isolates was among age groups 21-25 years (80.6%) followed by age groups 26-30 years (65.2%). Risk behaviours and predisposing factors like hygiene, sexual activity and contraception are possible reasons for the high incidence among the study population. The isolates were predominantly very sensitive to gentamycin, ciprofloxacin, norfloxacin and levofloxacin and therefore strongly recommended for the treatment of UTI as indicated in the study. Also, to reduce the incidence of urinary tract infections among the study population, improved personal hygiene and public facilities like toilets should be provided and students should abstain from risky behaviours that predispose them to uropathogen.

A comparative study of the prevalence of asymptomatic bacteriurea (ASB) among elderly diabetics and non diabetics with their antibiotic resistant pattern

Introduction: Asymptomatic bacteriuria is the most common problem in elderly diabetics may be due to high glucose concentration in the urine of such patients that favour the growth of uropathogens. Objective: This study was done to determine the prevalence of asymptomatic bacteriuria in diabetic and non diabetic patients, to determine the uropathogens responsible for ASB and also to know the antimicrobial susceptibility pattern of the pathogens. Materials and Methods: Urine samples were collected from elderly diabetics and non diabetics. Cultures Antibiotic susceptibility tests were performed using standard microbiological technique. Results: ASB was found to be 9.8% and 4.6% in diabetics and non diabetics Escherichia coli were the most common isolates followed by Klebsiella pneumonia, Imipenem, Nitrofurantoin were the most sensitive antibiotics against the urinary isolates. Conclusion: The patients may progress to symptomatic UTI so treatment is advisable in elderly cases of asymptomatic bacteriuria with poorly controlled diabetes but after culture and sensitivity. Keywords: Asymptomatic bacteriurea bacteriuria, Diabetics and non diabetics, Culture, Antibiotic susceptibility.

Multidrug-resistant and extended-spectrum beta-lactamase-producing uropathogens in children in Bhaktapur, Nepal

BackgroundThe emergence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing uropathogens has complicated the treatment of urinary tract infections (UTI). Paediatric UTI is a common illness, which if not treated properly, may lead to acute and long-term complications, such as renal abscess, septicaemia, and renal scarring. This study aimed to determine the prevalence of MDR and ESBL-producing uropathogens among children.MethodsDuring the study period (April 2017–April 2018), midstream urine samples were collected following aseptic procedures from children < 16 years in Siddhi Memorial Hospital. Standard culture and biochemical tests were performed to identify uropathogens and antimicrobial susceptibility test was done by modified Kirby-Bauer disc diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines. ESBL-producing uropathogens were screened by ceftazidime (30 μg) and cefotaxime (30 μg) discs, and confirmed by the combination disc tests: ceftazidime + clavulanic acid (30/10 μg) or cefotaxime + clavulanic acid (30/10 μg) as recommended by CLSI.ResultsWe processed 5545 non-repeated urine samples from the children with symptoms of UTI. A significant growth of uropathogens was observed in 203 samples (3.7%). The median age of the children was 24 months (interquartile range (IQR), 12–53 months). Escherichia coli (n = 158, 77.8%) and Klebsiella pneumoniae (n = 30, 14.8%) were common among the uropathogens. Among them, 80.3% were resistant to amoxycillin and 51.2% were resistant to cotrimoxazole. Most of them were susceptible to amikacin, nitrofurantoin, and ofloxacin. MDR was detected in 34.5% (n = 70/203) and ESBL producers in 24.6% (n = 50/203) of them. The proportion of MDR isolates was higher in children < 5 years (n = 59/153, 38.6%) than children ≥ 5 years (n = 11/50, 22%) (P = 0.03).ConclusionsNitrofurantoin, ofloxacin, and amikacin can be used for the empirical treatment for UTI in children in Bhaktapur, Nepal. MDR and ESBL-producing uropathogens are prevalent; this warrants a continuous surveillance of antimicrobial resistance.

Recurrent urinary tract infection in women and overactive bladder - Is there a relationship?

Overactive bladder (OAB) in women has similar symptomatology with other common urologic diseases such as recurrent urinary tract infection (UTI). Recent evidence showed that chronic low-grade bacterial bladder colonization might exacerbate OAB symptoms and could be the etiology of recurrent UTI. The high prevalence of lower urinary tract dysfunction is associated with OAB. Women with urgency urinary incontinence refractory to antimuscarinic therapy had more bacteria and a more diverse urinary microbiome. The bacterial reside in the superficial urothelial cells to form intracellular bacterial community and outbreak when the host innate immunity is low. Women with recurrent UTI are found to have highly prevalent voiding dysfunction and detrusor overactivity. These functional abnormalities will further damage the urothelial barrier integrity and create vulnerable to uropathogen invasion. The defective urinary microbiota is less common in women with recurrent UTI, suggesting that the normal flora in the urine might inhibit uropathogen growth and invasion. The defective urothelial barrier function, deficient basal proliferation, and deficient maturation might be owing to chronic suburothelial inflammation, resulting in activation of sensory nerves (causing OAB) and failure elimination of intracellular bacterial communities (causing recurrent UTI). Precision diagnosis and multidisciplinary treatment of the underlying pathophysiology of OAB and recurrent UTI is necessary.

Nitrofurantoin, monoliths and taboos

In 1968, Joseph Sachs et al. published a report in the New England Journal of Medicine on urinary concentrations of nitrofurantoin after its oral administration to an unspecified number of hospitalized individuals, some of whom required treatment for active urinary tract infection [1]. Recovery of nitrofurantoin from the urine appeared to be linearly related to creatinine clearance. In ‘uraemic’ individuals, whose creatinine clearances were not reported, the highest nitrofurantoin concentrations reached were considered probably too low to inhibit the growth of uropathogens, although neither MICs nor microbiological or clinical outcomes were reported.

Relationship between urinalysis findings and responsible pathogens in children with urinary tract infections

Pyuria, presence of bacteria, leukocyte esterase, and nitrite positivity in urinalysis should be considered together, and simultaneous urine culture test should be performed in the diagnostic evaluation of urinary tract infection (UTI). The absence of pyuria in urinalysis cannot exclude UTI in patients with suggestive clinical findings. It was aimed to assess relationship between urinalysis tests and uropathogen and to evaluate antibiotic resistance in children. The study included patients (aged 0-18 years) with significant uropathogen growth in urine culture tests. The patients' data regarding age, gender, results of urine microscopy, urine culture, and antibiogram were recorded retrospectively. Overall, 705 patients (562 girls, 143 boys) with significant growth in urine culture test were included. Median age was 72 months among girls and 12 months among boys. Most common uropathogens were Escherichia coli (79.6%) and Klebsiella pneumoniae (8.2%). E. coli was more commonly among girls (87%) and Klebsiella spp. among boys (53.3%). Pyuria was positive in urinalysis in 75% of patients. Pyuria presence was more common in patients with E.coli or Proteus spp. (80.6% and 71.4%, respectively) than those with Enterococcus spp. and Klebsiella spp. (52.0% and 53.3%, respectively). In culture antibiogram tests, ampicillin resistance was 100% in Klebsiella oxytoca and Enterobacter spp. and 72% in E. coli strains. No ceftriaxone resistance was observed in K. oxytoca, Citrobacter spp., Pseudomonas aeruginosa, and Enterobacter spp. Most UTIs were seen in older girls. Pyuria might be lacking in UTIs associated to Klebsiella spp. and Enterococcus spp., and absence of pyuria may not exclude UTI in patients with compatible clinical findings. Ceftriaxone is still an option in empirical treatment; unnecessary use of third-generation cephalosporins should be avoided, particularly in infections other than UTI. It was found that E. coli more commonly caused leukocyturia, leukocyte esterase positivity, and pyuria; that pyuria might be lacking in UTIs associated to Klebsiella spp. and Enterococcus spp. and that pyuria was more prevalent among girls. It is though that urine culture tests should be performed in children with suspected UTI even in the absence of pyuria because lack of pyuria may lead delay in diagnosis and treatment as well as renal scar formation.

Postoperative urinary tract infection after urogynecologic surgery: timing and uropathogens.

Although postoperative urinary tract infections (UTIs) after urogynecologic surgery are a common adverse event, there is no standardized postoperative time period used to assess this outcome, and the uropathogens unique to this sub-population of patients have not been well described. Our objective is to describe the timing and uropathogens of postoperative UTI after urogynecologic surgery. This retrospective study analyzed postoperative UTI occurring within 90days following urogynecologic procedures from November 2013 to January 2018 at a single academic institution. Postoperative UTI was defined as any uropathogen growth from standard urine culture. Continuous variables were compared with independent samples t-test and categorical variables with chi-square with Bonferonni corrections as appropriate. One hundred and two of 1085 (9.4%) patients experienced UTI; 63.7% occurred within 6weeks and 78.4% within 8weeks; 36.3% of UTIs occurred at a time period of 6weeks to 90days. Most commonly isolated uropathogens were Escherichia coli (47.8%) with an additional 11.2% extended-spectrum beta-lactamase (ESBL) Escherichia coli. Other bacteria included Enterococcus faecalis (10.4%), Klebsiella pneumoniae (9%), and one culture each for ESBL Klebsiella pneumoniae and vancomycin-resistant (VRE) Enterococcus faecium. More than one third of UTIs after urogynecologic surgery occur between 6weeks and 90days postoperatively. A plateau of UTI incidence occurs at 8weeks, a time period at which 78.4% of all UTIs were captured. Escherichia coli was the most commonly isolated uropathogen, and multi-drug-resistant bacteria were implicated in 12.8% of UTIs.

Antimicrobial Efficacy of Chromolaena odorata Extract against Bacteria Isolated from Patients with Urinary Tract Infection in Ondo State, Nigeria

Aim: This study is designed to isolate and identify the microorganisms associated with urinary tract infection in infected patients, determine the antimicrobial resistance pattern on the microbial isolates and the antimicrobial efficacy of solvents leaf extract of Chromolaena odorata on the resistant isolates.&#x0D; Methodology: Six hundred (600) mid-stream urine samples were collected from infected patients in some selected hospitals in Ondo State. The phytochemical screening of the plant was determined. The antibiotics sensitivity and antimicrobial activity of the plant extract was determined using plate assay and agar well diffusion methods.&#x0D; Results: Out of 600 urine samples analyzed, 472 (78.68%) showed significant growth of uropathogens comprising 197 (32.80%) male and 275 (45.83%) female. The isolated microorganisms comprise 5 Gram-positive bacteria (GPB), 9 Gram-negative bacteria (GNB) and 4 Candida sp. GNB account for 284(58.79%), GPB 158(32.71%) and Candida sp 41(8.48%). Escherichia coli showed high prevalence 90(18.63%) while Klebsiella ozaenae showed the least 11(2.27%). The phytochemical constituents of C. odorata extracts contained tannins, flavonoids, saponins, steroids and terpernoids and bacterial isolates showed resistant to all the antibiotics. Pseudomonas mendocina and P. putida showed the least resistant to C. odorata extracts. The MIC of the leaf extracts ranged from 5.0 mg/ml to 50.0 mg/ml. The methanol extract had the highest antimicrobial activity than n-hexane and chloroform extracts on the uropathogens.&#x0D; Conclusion: The high therapeutic potentials of C. odorata extract against the uropathogens could be used as alternative phytotherapy in herbal medicine to the commercial antibiotics in the treatment of urinary tract infections.

Evaluation of efficacy and tolerability of nitrofurantoin versus ciprofloxacin in patients of urinary tract infection: a comparative study

Background: UTIs are one of the most common infectious diseases encountered in out-patient departments on day to day basis. Nitrofurantoin and Ciprofloxacin are most commonly used antibiotics in the treatment of UTI. The present study was done to compare the efficacy and tolerability of nitrofurantoin and ciprofloxacin in patients of urinary tract infection.Methods: This prospective, open, randomized, parallel group, comparative study was conducted on 60 patients presenting with acute/uncomplicated or recurrent urinary tract infection in the outpatient Department of Urology, Rajindra Hospital attached to Govt. Medical College, Patiala, Punjab. They were divided into two groups, Group I and Group II of 30 cases each. Group I patients were put on Nitrofurantoin and Group II patients were put on Ciprofloxacin. Initially 100 patients were enrolled but only those who showed growth of uropathogens on baseline urine culture or those who completed the treatment were included in the study. The primary outcome measure was microbiological eradication on post treatment urine culture.Results: The age range of the patients in Group I and Group II was 19 to 68 years (43.40±14.58 years) and 20-60 years (39.77±13.49 years) respectively. The total no. of males and females who participated in this study were 32 (53.33%) and 28 (46.66%) respectively. The most common uropathogen associated with uncomplicated UTI was E. coli (80%), other organisms detected were Klebsiella species (16.67%), Staphylococcus aureus (3.33%) and Providencia (3.33%). Post treatment urine culture results showed significant difference between two groups, 5 patients (16.67 %) in case of Group I and 14 patients (46.67%) in case of Group II showed growth of micro-organisms post treatment. P-value comes out to be 0.017 which is significant.Conclusions: In this era of super bugs, nitrofurantoin is more efficacious than ciprofloxacin in the treatment of UTI. E. coli was found to be major organism causing UTI. Ciprofloxacin is less effective due to increasing antibiotic resistance among uropathogens. Both the drugs were well tolerated, no major significant adverse effects were encountered.

Efektivitas in vitro Alfa Mangostin Pada Pertumbuhan Bakteri Uropatogen Escherichia coli Multiresisten

Background. The incidence of Multi Drug Resistant (MDR) in extraintestinal E. coli has become a global problem in the world. In Indonesia, the greatest resistance to the uropathogen E. coli is resistant to ampicillin (91.9%), ciprofloxacin (83.7%) and cefixime (67.6%). Therefore it takes effort for the treatment of MDR uropathogen E. coli, one of them are development of new antibiotics from herbal isolates of Garcinia mangostana L., a-mangosteen. This study examined the activity of a-mangosteen in vitro on the growth of MDR uropathogen E. coli.Methods. Treatment of uropathogen E. coli is performed in vitro, using a-mangosteen with a range of levels 14 - 450 �g/mL. The antibacterial activity of a-mangosteen is measured by determine at the growth or death of bacteria at each concentration using indirect methods, which is absorbance reading. Uropathogen E. coli that had been treated with various concentration of a-mangosteen incubated for 18-20 hours, then read an absorbance at wavelenght 625 nm using a spectrophotometer.Result. The Minimal Inhibitory Concentration (MIC) of a-mangosteen in this study was 450 �g/mL. Based on the linear regression (STATA 13.1) relationship between concentration of a-mangosteen and activity of growth inhibition of bacteria, obtained the F test value 0.0001 &lt; 0.05, states that all concentrations of a-mangosteen simultaneously have a significant influence on the growth of uropathogen E. coli.Conclusion. MIC value is relatively large causing a-mangosteen activity against Gram-negative bacteria needs to be studied further. Potentially relevant activity in the clinic will occur if the value of in vitro MIC &lt; 100 �g/mL. Likewise, the pharmaceutical industry prefers the development of antibiotics that have in vitro MIC values = 2 �g/mL.

Isolation and Identification of Urinary Tract Infectious Bacteria and Exploring their Anti-drug Potential against Some Common Antibiotics

Urinary tract infection caused by bacteria leads to inflammation and over growth of uropathogens and prevalence of infection for both genders, but women is more vulnerable especially at the sexually active ages. Nine isolates from sixteen patients were microscopically tested, characterized, identified using different media and biochemical tests. The highest rate of isolated bacteria were Escherichia coli and Staphylococcus aureus (23.52%), followed by Staphylococcus saprophyticus, Entrococcus faecalis (17.64% and 8.82), respectively and Entrobacter aerogenes, Klebsiella pneumonia, Proteus vulgaris and Pseudomonas aeruginosa were (5.88%), only 2.94% of bacteria was detected as Proteus miralilis. Effect of different antibiotics was reported, maximum effect showed by Gentamycin and Chloramphenicol (80% and 70%), respectively. Contrastingly, levofloxacin 50%, Amikacin and Nitrofurantoin 40%, Ceftriaxone and Amoxicillin 30%, Cefixime 10%. In conclusion, unsuitable medication prior to urine culturing causes to increase prevalence of gram positive bacteria as much as gram negatives and developing multidrug resistance.

Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article.

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.