Urinary Tract Infection Research Articles

Aerococcus urinae urinary tract infections: A case series.

Aerococcus urinae is an uncommon uropathogen that mainly affect the elderly with predisposing conditions. Aim of the present study was to investigate the clinical and microbiological characteristics of patients with urinary tract infections (UTIs) by A. urinae and determine the antimicrobial susceptibility patterns of the isolates, over the last 3 years at our institution. The medical records and microbiological data of patients from whom A. urinae was isolated from urine cultures at the university hospital of Heraklion, Crete, Greece, between 2020 and 2022, were retrospectively analyzed. The isolates were identified by the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Susceptibilities for antimicrobial agents were determined by the disk diffusion method and results were interpreted using the 2024 EUCAST breakpoints. The minimum inhibitory concentration for fosfomycin was evaluated by the MIC Test Strip method. A. urinae was encountered in cultures of 24 patients. The median patient's age was 72 years, and females slightly outnumbered males. Underlying diseases such as urologic disease, chronic lung disease, chronic kidney disease, heart disease, diabetes mellitus and dementia were found in 79.2% of patients. Two of the patients did not meet the criteria for a UTI. Susceptibility rates to penicillin, amoxicillin, meropenem, ciprofloxacin, levofloxacin, rifampicin, vancomycin, nitrofurantoin and fosfomycin were 100%, 100%, 100%, 83.3%, 79.2%, 100%, 100%, 95.8%, and 91.7%, respectively. Further surveillance studies and clinical trials are needed to confirm our data and to investigate the in vivo efficacy of the antimicrobial agents to treat UTIs by A. urinae.

Epidemiology, microbiological profile and susceptibility pattern of uropathogens from a tertiary care hospital in central India

Urinary tract infections (UTIs) are the second most common infection in the community, whereas in hospitals, they are the most common healthcare-associated infections. Monitoring factors like the most common causative organisms and their susceptibility pattern is essential for tailored management and practicing antimicrobial stewardship. This study was done to determine the epidemiology, microbiological profile, and susceptibility pattern of uropathogens to make better antibiotic policy.: This was a retrospective descriptive study done at the Department of Microbiology, Pt. JNM Medical College, Raipur, Chhattisgarh in which analysis of the culture isolates obtained from urine samples received between January 2022 to December 2022 was performed.: Out of 2893 urine samples, 784 (27.1%) showed significant growth on culture. Females were more affected than males with male to female ratio being 1:2.3. Most common causative organism found in our study was (41.9%) followed by species (23.9%), non-albicans species(11.09%) and (10.3%). isolates showed 100% susceptibility to fosfomycin; 93% for nitrofurantoin, and 93% for carbapenems. In the case of isolates of the susceptibility percentage for nitrofurantoin and carbapenems were 59% and 82% respectively. In isolates were 100% susceptible to Teicoplanin and Fosfomycin, 82% for Nitrofurantoin.: followed by species the most common uropathogen. Nitrofurantoin and Fosfomycin were the most effective antibiotics against uropathogens.

Real-world safety of dapagliflozin plus metformin in patients of type 2 diabetes mellitus in China: Post-hoc analysis of the DONATE study.

DONATE (NCT03156985) is a large-scale real-world study investigating the safety of dapagliflozin in Chinese type 2 diabetes mellitus (T2DM) patients. This post-hoc analysis aims to further evaluate the real-world safety of dapagliflozin plus metformin. Safety outcomes were assessed in patients receiving concomitant dapagliflozin and metformin, with or without other antidiabetics. The safety of dapagliflozin-based dual-therapies and dapagliflozin and metformin-based triple-therapies were also analysed. Among the 2,990 patients in DONATE, 2,165 (72.4 %) received concomitant metformin. Among these 2,165 patients, 780 (36.0 %) experienced ≥ 1 adverse event (AE), 129 (6.0 %) experienced serious AE (SAE), and 96 (4.4 %) experienced AE leading to dapagliflozin discontinuation. The most common AEs were upper respiratory tract infection (4.0 %), urinary tract infection (UTI, 2.1 %) and constipation (1.5 %). The most common AEs of special interest of dapagliflozin were UTI (2.3 %), genital tract infection (1.5 %) and hypoglycaemia (1.1 %). In the dapagliflozin and metformin dual-therapy subgroup, the incidences of AE, SAE and AE leading to dapagliflozin discontinuation were 26.7 %, 2.5 %, and 1.9 %, respectively, numerically lower than that of the total population and most other dual-therapy subgroups. These patients also had numerically improved metabolic outcomes than baseline. Dapagliflozin and metformin combination therapy is well-tolerated in real-world Chinese T2DM patients.

Pathogenic Bacteria Caused Urinary Tract Infections: A Review

The urinary system is one of the most vital organs susceptible to infection; especially bacterial ones. Urinary tract infections (UTIs) mean colonization of urinary tracts by pathogenic microorganisms leading to inflammation of urinary system. In this study, we review the basic concepts of the most important pathogenic microbes infected this system. Enterobacteriaceae is a large group of Gram-negative bacillus bacteria that are naturally found as commensals in the intestine and are pathogenic and opportunistic, exploiting any opportunity to cause many infections, and they are the main cause of urinary tract infections. Uropathogenic E. coli strain causes approximately 90% of UTIs. Besides, Klebsiella pneumoniae represents most important pathogenic bacteria causing diseases, especially UTIs in children. It was found, that severity of this infection mainly related with virulence of causative bacteria as well as the host’s immune system.

Nitrofurantoin Induced Lung Disease

Nitrofurantoin is a synthetic nitrofuran antimicrobial commonly used for the treatment and prevention of recurrent urinary tract infections (UTIs). Although rare nitrofurantoin can cause acute and chronic lung diseases. We report the case of an 81-year-old woman diagnosed with interstitial lung disease (ILD) due to long-term use of Nitrofurantoin for UTI prophylaxis. Despite widespread lung parenchymal changes in the form of fibrosis and ground glass opacities, she responded very well to corticosteroids. This case report highlights the importance of early recognition and favorable response to corticosteroids in nitrofurantoin-induced ILD. Keywords: Nitrofurantoin, Lung Diseases, Interstitial Fibrosis, Corticosteroid.

The Analysis Study of Safety and Outcome of Ureteroscopy During Pregnancy: A Comprehensive Systematic Review

Background: Symptomatic urolithiasis in pregnancy can result in significant morbidity, causing conditions such as renal colic, urinary tract infections, and ureteral obstruction. This systematic review aim to analyze the safety and outcomes of uretrhoscopy for pregnant women. Methods: The study followed PRISMA 2020 guidelines, reviewing English-language publications from 2014 to 2024. Editorials, duplicate reviews from the same journal, and papers lacking a DOI were excluded. The literature search was conducted using PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 2,172 articles were initially identified through online databases (PubMed, SagePub, SpringerLink, and Google Scholar). After three rounds of screening, eight relevant studies were selected for full-text analysis. Conclusion: Ureteroscopy is a safe, effective, and cost-efficient treatment for ureteral calculi during pregnancy. Early intervention minimizes complications, and URS remains a successful option for managing obstructive uropathy. Future research should optimize protocols and assess long-term outcomes for improved care.

Is Intravesical Gentamicin the New Gold Standard to Manage Refractory Urinary Tract Infections?-Experience From a Dedicated Multidisciplinary Complex UTI Clinic.

To assess the effectiveness of intravesical gentamicin in managing recurrent urinary tract infections (rUTIs) refractory to first- and second-line treatments. This single-centre prospective cohort study included 41 patients treated with intravesical gentamicin over a 24-month period from 2021 to 2023. A multidisciplinary team comprising functional urologists, microbiologists, and specialist nurses was involved in the decision-making process and in designing the treatment protocol. Patients self-administered gentamicin instillations into the bladder according to a 6-month instillation schedule. Patients were followed up during and after the treatment period to assess the treatment response. A total of 41 patients with rUTIs were treated using the 6-month intravesical gentamicin regimen. Of these, 10 were male and 31 were female, with a mean age of 53 years. E. coli was isolated from urine cultures in 19 patients (46%), while 19 patients had multiple organisms. Serum gentamicin levels were undetectable in all patients 1 week after treatment initiation. The mean follow-up period was 15 months with minimum follow up of 6 months for all patients. Following gentamicin administration, hospital admission rates due to urosepsis decreased from 46% to 5%, and the prevalence of multidrug-resistant organisms in urine cultures decreased from 44% to 10%. A significant reduction in UTI frequency was observed in 80.5% of patients, with 71% reporting good to excellent Patient Global Impression of Improvement (PGI-I) scores. Additionally, 76% of patients reported a significant improvement in Quality of Life (QoL). In our cohort of patients with recurrent and refractory UTIs, intravesical gentamicin instillations has shown to be both safe and effective, leading to notable improvements in patients' symptoms and QoL.

An insight into Pittaja Mutrakrichra w.s.r. to Lower Urinary Tract Infection with mechanism, risk factors & prevention

In Ayurveda, diseases are named after taking into consideration of certain criteria which are very much significant. A disease named on the basis of Pravrutti of Mootra associated with difficulty in Pravrutti is Mutrakrichra i.e., passing urine with difficulty or pain. Eight types of Mutrakrichhra are described in details in Madhav Nidana - i.e., Vattaja, Pittaja, Kaphaja, Sannipataja, Shalyaja, Ashmarija, Shukraja, Purishaja Mutrakrichhra. Pittaja Mutrakrichhra was well acknowledged in Samhitas with different treatment modalities, which can be concurrent to Lower urinary tract infections on theoretical and clinical symptomatology of disease. Urinary Tract Infection (UTI) is defined as multiplication of organism in urinary tract.[1] Urinary tract infection is the inflammation of the tissues of the urinary tract.[2] Upper urinary tract infection is infection involving the kidney and lower urinary tract infection is infection involving the bladder, prostate, and urethra.[3] Hence in the present study, an attempt is made to critically analyze the disease Pittaja Mutrakrichra with its Nidana, Samprapti, Lakshana and with the disease Lower urinary tract infection. Lower urinary tract infection can be reduced by drinking plenty of fluids and completely emptying the bladder frequently. Menstrual hygiene changes sanitary pads or tampons regularly to maintain cleanliness and to prevent bacterial growth.

Incidence of Urinary Tract Infections, Etiological Agents, and Antibiotic Susceptibility Among Pregnant and Non-Pregnant Women in Amedi Region, Iraq

Urinary tract infection is a bacterial infection caused by bacteria from the digestive tract entering the urinary tract. It is more prevalent in women and remains the most common bacterial infection in humans. The study aimed to assess the prevalence of urinary tract infections (UTIs) in pregnant women, identify and diagnose uropathogenic bacteria, and examine the antibiotic susceptibility of the isolated bacteria. A total of 283 urine specimens were collected from pregnant and non-pregnant females of different ages who visited Amedi hospital between October 2020 and January 2021. The samples were cultured and incubated on Blood agar and MacConkey agar plates for 24 hours at 37°C. Bacterial isolates were identified and their antibiotic sensitivity was assessed using the Vitek-2 method. The study found a total UTI rate of 42.4% (120/283), with higher rates in pregnant patients (58.3%) compared to non-pregnant patients (41.7%). Among 120 positive urine cultures, bacterial isolates were identified in 92.5% (111/120), with Gram-positive bacteria being more prevalent (51.4%) than Gram-negative (48.6%). The most common Gram-negative bacteria was Escherichia coli (29.7%), while Gram-positive bacteria included Enterococcus faecalis, Staphylococcus haemolyticus, and Streptococcus agalactiae (each 12.6%; 14/111). The rate of fungal positive cultures (Candida spp.) was 7.5%. Gram-negative isolates showed high sensitivity to tigecycline (99.0%) and ertapenem (80.6%), but low sensitivity to ampicillin (2.7%) and cefuroxime (16.1%). Gram-positive isolates were highly sensitive to linezolid (98.7%) and tigecycline (98.5%). The findings of this study are valuable for understanding the nature of urinary tract infections (UTIs) and guiding appropriate treatment, leading to a reduction in the misuse of antibiotics. Keywords: Urinary tract infection; Pregnancy; Antibiogram; Uropathogenic bacteria; Iraq.

In-vitro and in-silico assessment of thiazole-thiazolidinone derivatives as selective inhibitors of urease and α-glucosidase.

Current research work aims to synthesize hybrid compounds with a thiazole-thiazolidinone structure, as potent inhibitors of urease and α-glucosidase enzymes. These compounds were characterize through1HNMR,13CNMR and HREI-MS techniques. These compounds were also evaluated for their potential to inhibit urease and α-glucosidase enzymes for the treatment of urinary tract infections (UTIs) and diabetes treatments. Moreover, molecular docking and ADMET analysis was carried out to confirm biological outcomes. Compounds-4 (IC50 = 1.80 ± 0.80 and 3.61 ± 0.59 μM against urease and α-glucosidase, respectively) exhibited significant effectiveness in inhibiting the activity of both enzymes in comparison to the conventional inhibitors thiourea and acarbose. Molecular docking experiments showed that potent compounds exhibited favorable binding orientations in the active sites of urease and α-glucosidase playing a pivotal role in inhibition profile of these compounds. These compounds were also investigated for their drug likeness and were found with desirable attributes for pharmaceutical development. Based on the findings of this research, these compounds have the potential to be developed into effective anti-diabetic and anti-urease treatments in the future.

Evaluation of the Efficacy of Piperacillin/Tazobactam in Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Urinary Tract Infections: A Systematic Review of the Literature.

To evaluate the efficacy of piperacillin/tazobactam (PTZ) for the treatment of extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE) urinary tract infections (UTIs). A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards on PubMed, MEDLINE, Embase, Web of Science Core Collection, and Cochrane Central through July 2024. Studies providing efficacy data associated with PTZ in patients ≥18 years old experiencing an ESBL-PE UTI that documented clinical and microbiological cure data were included. A total of 577 articles were obtained for screening. After applying the inclusion and exclusion criteria, 7 studies comparing PTZ with carbapenems comprised of 1156 patient cases were analyzed. Piperacillin/tazobactam was found to be noninferior to carbapenems in the treatment of both uncomplicated and complicated UTI's caused by ESBL-PE. The observed noninferiority encompassed clinical response, clinical cure, and microbiological cure outcome metrics. Although not specifically evaluated in this systematic review, adverse effects associated with PTZ were found to be minimal and lesser in incidence than with the carbapenem comparators in aggregate. While a definitive dosing strategy remains elusive, a PTZ total daily dose of 13.5 g infused over 3 to 4 hours may be appropriate for this indication. Piperacillin/tazobactam may be an effective carbapenem-sparing agent for the treatment of ESBL-PE UTIs that show in-vitro susceptibility to PTZ. However, additional robust randomized clinical trials are still needed to validate the findings of this review and determine the best dosage regimen of PTZ for ESBL-PE UTIs.

Pivmecillinam for Uncomplicated Acute Cystitis: A Contemporary Review.

To review the evidence and discuss use of pivmecillinam in uncomplicated acute cystitis. A literature search was conducted utilizing PubMed (from 2000 through August 2024) and ClinicalTrials.gov. Medical Subject Headings (MeSH) terms, such as mecillinam or pivmecillinam and urinary tract infections, were utilized. Additional references were identified by reviewing literature citations. Articles were limited to English language publications evaluating the efficacy or safety of pivmecillinam for urinary tract infections (UTIs) in adult populations. Data from 6 randomized controlled trials support pivmecillinam for acute uncomplicated cystitis at doses of 200 to 400 mg 3 times daily for 3 to 7 days, with more consistent clinical and bacteriologic cure observed with 400 mg doses and longer therapy durations. Clinical evaluation of 400 mg 2 to 3 times daily is available with use more common in non-US Food and Drug Administration (FDA)-approved populations, such as men, pregnancy, and multidrug resistant infections. There are limited data supporting pivmecillinam for pyelonephritis; routine use is cautioned until further clinical data are available. As resistance to first-line antimicrobials rises, the need for safe and effective treatment options remains high. Pivmecillinam represents a new therapeutic option available in the United States for outpatient management of uncomplicated acute cystitis. Pivmecillinam could be a key agent for uncomplicated acute cystitis. Utilization will likely be cost driven, but the promise of low resistance encourages the place in therapy when other agents are not susceptible to infecting uropathogens.

Case Report of a Patient with Burkholderia cepacia Urinary Tract Infection with Prostatitis and Prostatic Micro Abscess

Case Report of a Patient with Burkholderia cepacia Urinary Tract Infection with Prostatitis and Prostatic Micro Abscess

Cathelicidin in Urinary Tract Diseases: Diagnostic, Prognostic and Therapeutic Potential of an Evolutionary Conserved Antimicrobial Protein

Despite being one of the most common infectious diseases, urinary tract infections (UTIs) still represent a challenge for clinicians to diagnose and treat, especially in the era of growing antibiotic resistance among uropathogenic bacteria. Recent studies investigating the pathophysiology of UTIs have discovered the prominent role of antimicrobial peptides in the urinary tract defense system. Cathelicidin is an evolutionary conserved antimicrobial peptide encoded by one single gene in humans. Except for being stored in neutrophil cytoplasmic granules, cathelicidin is produced by uroepithelial cells rapidly upon contact with a uropathogen, even before leukocytes invade the urinary tract. In addition to its bactericidal effect, cathelicidin acts as a chemoattractant for multiple immune cells and a potent inductor of numerous cytokine synthesis. Such a crucial role in the initial pathogenesis of a UTI makes cathelicidin a potential biomarker for an early UTI diagnosis. Indeed, multiple studies over the last two decades have proved the potential clinical utility of cathelicidin as a UTI diagnostic biomarker. Furthermore, since patients after the resolution of a UTI have been found to express a lower urinary cathelicidin level than healthy controls, decreased cathelicidin levels have been suggested as a risk factor for developing UTI recurrence. Therefore, measuring cathelicidin levels in urine might help in distinguishing patients with a higher risk for a recurrent UTI. Interestingly, except in UTIs, cathelicidin has also been evaluated in other urinary tract diseases and proposed as a biomarker for diagnosing severe vesicoureteral reflux (VUR) and for recognizing renal scar development in patients with VUR. Finally, a prominent role in UTI pathogenesis also makes cathelicidin an attractive therapeutic target for treating UTIs and, lately, different therapeutic agents up-regulating cathelicidin expression have been investigated in this matter. Therefore, the present review aims to summarize the current body of knowledge on the diagnostic, prognostic and therapeutic potential of cathelicidin in urinary tract diseases. For this purpose, three databases (Scopus, Medline and Web of Science) were extensively searched to cover all the published articles. This exhaustive review will update clinicians on the contemporary state of knowledge about the potential clinical utility of cathelicidin in urinary tract diseases and hopefully encourage further research, resulting in improvement in the current management of urinary tract diseases.

Antimicrobial Susceptibility Trends in E. coli Causing Pediatric Urinary Tract Infections in the United States

Urinary tract infections (UTIs) are among the most common pediatric infections. This study evaluated the antimicrobial susceptibility patterns of 3511 uropathogenic E. coli (UPEC) isolated from pediatric patients in the United States from 2014 to 2023. The database from the SENTRY antimicrobial surveillance program from 89 medical centers was utilized as a data source. The antimicrobial susceptibility was tested using the microbroth dilution technique against 24 antimicrobial agents. MICs were determined using the CLSI/EUCAST/FDA breakpoint criteria. All the antimicrobials reported susceptibility rates above 80% except for tetracycline (76.2%), trimethoprim–sulfamethoxazole (69.7%), and ampicillin–sulbactam (55.7%). During the study period, the susceptibility rates remained stable for most antimicrobial agents. However, significant differences were observed among age, gender, and U.S. census regions, with the Middle Atlantic showing the lowest and the Mountain region the highest susceptibility rates, for most antimicrobials. The incidence of ESBL UPEC increased from 7.1% to 10.8% between 2014 and 2023, while the prevalence of the MDR phenotype remained relatively stable. The prevalence of both ESBL and MDR phenotypes was highest among infants and young children (0–24 months), with the highest resistance rates from the Pacific region. Knowledge of the landscape of antibiotic resistance in pediatric UPEC will help healthcare providers to better tailor empiric treatment regimens for most UTI infections.

Genetic Profiling of Raoultella spp. in Pediatric Clinical Samples: Insights from Bauchi, North East Nigeria

Background: Raoultella species, are gram-negative bacteria of Enterobacteriaceae family, originally classified under Klebsiella, were reclassified in 2001 as a distinct genus. Members have emerged as notable pathogens, mostly in hospitalized and immunocompromised patients. Though once considered opportunistic, Raoultella spp. are now linked to various infections, including bacteremia, urinary tract infections, and neonatal sepsis, with antibiotic-resistant strains posing significant challenges in clinical settings. The true prevalence of Raoultella infections may be underreported due to diagnostic challenges, making early identification crucial for improved management in high-risk populations, particularly pediatrics. Raoultella species, emerging pathogens are increasingly linked to pediatric and neonatal infections in clinical settings. Aim: isolation and accurate identification of Raoultella species from pediatric clinical samples to address challenges in identification and genetic characterization. Study Design: This is a prospective, cross-sectional study involving pediatrics aged 0-5 years. Place and Duration of Study: Pioneering study in Bauchi, North-East Nigeria, from August 2021 to January 2022. Methodology: Samples from 262 pediatric patients with septicemia symptoms were processed at Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH). The VITEK 2 Compact system was used for initial identification, while PCR amplification of the 16S rRNA gene confirmed Raoultella species. The genomic DNA of identified isolates underwent sequence and bioinformatics analysis. Results: The phylogenetic tree constructed using the 16S rRNA sequences of the isolates and reference strains visually represent the genetic relationships. The high homology observed in the sequence alignment is reflected in the phylogenetic clustering, with isolates RoP_2 (PQ213811), RoP_3 (PQ213812), and RoP_4 (PQ213813) grouping closely with known Raoultella planticola strains. This close genetic relationship further supports the species identification suggested by the gel electrophoresis and homology data. However, RoP_1 (PQ213810), identified as Proteus mirabilis through BLAST analysis of its 16S rRNA sequence, shows slightly lower homology with Raoultella planticola reference strains. In the phylogenetic tree, RoP_1 is positioned slightly apart from the other isolates, indicating some genetic variability. This discrepancy suggests that while RoP_1 shares characteristics with Raoultella, the distinct genetic makeup warrants further investigation to confirm its identification as R. planticola or otherwise. Conclusion: The phylogenetic analysis supports the identification of isolates RoP_2, RoP_3, and RoP_4 as Raoultella planticola, showing close genetic relationships. However, RoP_1 exhibits genetic variability, clustering separately and aligning more closely with Proteus mirabilis, suggesting the need for further investigation to confirm its species identification.

Rapid and accurate testing for urinary tract infection: new clothes for the emperor.

SUMMARYUrinary tract infection (UTI) is among the most common infections in clinical practice. In some cases, if left untreated, it can lead to pyelonephritis and urosepsis. In other cases, UTI resolves without treatment. Clinical diagnosis is typically based on patient symptoms and/or urinalysis, including urine dipsticks. The standard urine culture method is sometimes employed to identify the suspected urinary pathogen (uropathogen) and/or guide antimicrobial choice, but results are rarely available before 24 h. The standard urine culture method also misses fastidious, anaerobic, and slow-growing uropathogens and rarely reports polymicrobial infections. The unexplained combination of negative urine cultures with persistent urinary tract symptoms is distressing to both patients and clinicians. Given the broad appreciation of the advantages provided by rapid testing (e.g., for COVID-19 or influenza A), a rapid, accurate diagnostic test is needed to deliver timely treatment to patients seeking care for UTI that optimizes antibiotic stewardship. Herein, we discuss progress being made toward an accessible, timely (i.e., within hours), accurate assay with results that are clinically useful for the treating clinician within the timeframe of the infection (i.e., the growth rate of the pathogen(s)). New and emerging uropathogens often overlooked by current diagnostic techniques are also reviewed.

ISOLATION AND CHARACTERIZATION OF ESCHERICHIA COLI IN UTI PATIENTS OF DISTRICT D.I.KHAN AND TO PROBE THEIR ANTIBIOTIC RESISTANCE

Background: Globally urinary tract infections are present predominantly and mostly UTIs are present or noticed in the developing countries like Pakistan, Bangladesh etc. There are multiple factors in spread of UTIs like microbes, taking certain medicines, sexual activities, poor hygiene, not taking enough water etc. Objectives: The prevalence of UTIs and development of resistance against the antibiotics is due to unjustified use of antibiotics. Methodology: We performed a study in a remount area of Khyber Pakhtunkhwa i,e Dera Ismail Khan. We conducted a research study consist of a three months duration. Hundred (100) urine samples were collected from the patients who visited District Head Quarter (DHQ) teaching hospital Dera Ismail Khan. Patients having different age groups were included in study, Results: After processing samples, the number of samples having E.coli i,e positive samples were 73 in number, which were confirmed on the basis of different tests. The prevalence of UTIs due to E. coli organism was noticed increased in female patients (69 %) as compared to male patients and its prevalence was 31%.When the isolated E. coli strain were tested against different antibiotics, showed that those strains which were isolated from urine samples of the male patients of age group 61 to 80 years showed higher sensitivity against PTZ, NF, FOS, AK, IMP, and SCF, while in female high rate of sensitivity against PTZ, NF, FOS, AK, IMP, and SCF antibiotics was observed against E. coli strains which were isolated from the patients having age from 21 to 40 years Likewise E.coli isolates were sensitive against Imipenem, Peracillin + Tazobactam, Cefoperazone + sulbactam, Fosfomycin, Amikacin, Nitrofurantoin, Peracillin and Tambactam irrespective of age of the patients from which bacteria were isolated. Conclusion: Furthermore, present study also revealed, that the E. coli has developed resistance against commonly used antibiotics which is a serious concern to worry about and serious steps should be taken by the authorities to stop frequent use of antibiotics without proper prescription to avoid this issue.

Expression of concern: Selective isolation and eradication of E. coli associated with urinary tract infections using anti-fimbrial modified magnetic reduced graphene oxide nanoheaters.

Expression of concern for 'Selective isolation and eradication of E. coli associated with urinary tract infections using anti-fimbrial modified magnetic reduced graphene oxide nanoheaters' by Fatima Halouane et al., J. Mater. Chem. B, 2017, 5, 8133-8142, https://doi.org/10.1039/C7TB01890H.

Effective Antifungal Compounds of Lactococcus lactic Against Vulvovaginal Candidiasis for Women in Thi-Qar Governorate

Abstract One hundred and fifty-four samples were collected from Bint Al-Huda Teaching Hospital in Thi-Qar Governorate divided to 104 women infected urinary tract infection (UTI) and 50 healthy women as control group. Vulvovaginal Candidiasis (VVC) is the most opportunistic yeast infection produced by species of Candida in both pregnant and non-pregnant women were examined in this study. Lactococcus lactic (ATCC 11454) extracted and chemical compounds identified by Gas Chromatography, the extract of L. lactic inhibited all Candida isolates in agar well diffusion assay and the inhibition zone, it were (12, 11, 11, 11, 10 mm) for C. albicans, C. dublniesis, C. glabrata C. krusei and C. parapsilosis respectively, while minimum inhibiter concentration were (64, 128, 128, 128, 128μg/ml) for C. albicans, C. dublniesis, C. glabrata C. krusei and C. parapsilosis respectively, the chemical compounds of L. lactic unable inhibit efflux pump of all clinical Candida isolates after treated with (40, 20, 10, 5 mg/ml) of ethidium bromideOne hundred and fifty-four samples were collected from Bint Al-Huda Teaching Hospital in Thi-Qar Governorate divided to 104 women infected urinary tract infection (UTI) and 50 healthy women as control group. Vulvovaginal Candidiasis (VVC) is the most opportunistic yeast infection produced by species of Candida in both pregnant and non-pregnant women were examined in this study. Lactococcus lactic (ATCC 11454) extracted and chemical compounds identified by Gas Chromatography, the extract of L. lactic inhibited all Candida isolates in agar well diffusion assay and the inhibition zone,