Nosocomial Urinary Tract Infections Research Articles

<i>Burkholderia</i> Cepacia Causing Nosocomial Urinary Tract Infection in Children

Purpose: Burkholderia cepacia is an aerobic, glucose–non-fermenting, gramnegative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. Methods: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. Results: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28. 6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazoletrimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. Conclusion: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.

The Reduction in Antibiotic Use in Hospitals.

Over 350 000 patients are treated in German hospitals for sepsis or pneumonia each year. The rate of antibiotic use in hospitals is high. The growing problem of drug resistance necessitates a reconsideration of antibiotic treatment strategies. Antibiotics were given liberally in the years 2010 and 2011 in a German 312-bed hospital. Special training, standardized algorithms to prevent unnecessary drug orders, and uniform recommendations were used in 2012 and 2013 to lessen antibiotic use. We retrospectively studied the hospital's mortality figures and microbiological findings to analyze how well these measures worked. Antibiotic consumption fell from 67.1 to 51.0 defined daily doses (DDD) per 100 patient days (p <0.001) from the period 2010-2011 to the period 2012-2013. The mortality of patients with a main diagnosis of sepsis fell from 1% (95/305) to 19% (63/327; p = 0.001), while that of patients with a main diagnosis of pneumonia fell from 12% (22/178) to 6% (15/235; p = 0.038). The overall mortality fell from 3.0% (623/ 20 954) to 2.5% (576/22 719; p = 0.005). In patients with nosocomial urinary tract infections with Gram-negative pathogens (not necessarily exhibiting three- or fourfold drug resistance), the rate of resistance to three or four of the antibiotics tested fell from 11% to 5%. Reducing in-hospital antibiotic use is an achievable goal and was associated in this study with lower mortality and less drug resistance. The findings of this single-center, retrospective study encourage a more limited and focused approach to the administration of antibiotics.

Study of virulence factors of E. coli in community and nosocomial urinary tract infection

Abstract Background E. coli is the commonest causative agent of urinary tract infections (UTIs). E. coli possesses several virulence factors. Community-acquired (CA) strains of E. coli are considered as more virulent as compared to nosocomial strains. Objectives To study virulence factors of E. coli in CA and nosocomial isolates of UTI. Methods Various virulence factors, i.e. hemolysin production, hemagglutination, serum resistance, cell surface hydrophobicity, and gelatinase production, were studied in the E. coli isolates from patients with CA and nosocomial UTI. Results In both CA and nosocomial E. coli isolates, hemagglutination was the most common virulence factor. Other virulence factors produced in E. coli isolates were hemolysin (26.3%), serum resistance (12.8%), cell surface hydrophobicity (9.1%), and gelatinase (3.3%). Conclusions Production of virulence factors was more common in isolates of CA UTI as compared to nosocomial UTI ( p

NOSOCOMIAL INFECTIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

Abstract: Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period. Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients. Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli ( 24,0%).

Complete Genome Sequence of Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae Siphophage Sushi.

Klebsiella pneumoniae is a Gram-negative bacterium in the family Enterobacteriaceae. It is associated with numerous nosocomial infections, including respiratory and urinary tract infections in humans. The following reports the complete genome sequence of K. pneumoniae carbapenemase-producing K. pneumoniae T1-like siphophage Sushi and describes its major features.

Drug Resistance and Serotyping of Uropathogenic Escherichia coli Among Patients With Urinary Tract Infection in Rasht, Iran

Background:: Urinary Tract Infection (UTI) is one of the most common reasons for human to seek medical advice and is also one of the most frequently occurring nosocomial infections. Nosocomial UTIs are almost exclusively complicated with a broad spectrum of etiological pathogens. Escherichia coli remains the predominant uropathogen (80%) isolated in community-acquired infections. Objectives:: The aim of this study was to determine the local incidence of UTIs, identification of Uropathogenic E. coli (UPEC), serotyping and strains antimicrobial resistance of E. coli isolated from these patients. Patients and Methods:: In this prospective cross-sectional study, in order to isolate and identify bacterial agent (UPEC) causing UTI and to identify it’s sex and age distribution, a total 150 urine samples through simple random sampling method were analyzed for identification of bacterial isolates. Lactose fermenting colonies on MacConkey’s agar were processed and identified as E. coli by standard biochemical tests. Antibiotic susceptibility tests were performed with disk diffusion tests using Kirby-Bauer method on E. coli isolated from 110 cases with UTI aged from 1 year to 85 years and serotyping achieved by slide agglutination method. All data analyzed using SPSS-21 software. Results:: Majority of UPEC belonged to serotype O1, O2, O4, O20, O25, O44, O64 and O78. Majority of the isolates were resistant to routinely used antibiotics amoxicillin, cotrimoxazole, tetracycline and gentamicin. Most of the isolates were sensitive to nalidixic acid, ciprofloxacin, nitrofurantoin and ceftazidime. Conclusions:: The present study revealed that serotype O25 was isolated with maximum frequency followed by O2, O6, O1, O78, O44, O20 and O64 respectively.

Spread of Enterococcal Surface Protein in Antibiotic Resistant Entero-coccus faecium and Enterococcus faecalis isolates from Urinary Tract Infections.

Enterococci rank among leading cause of nosocomial bacteremia and urinary tract infection in hospital and community acquired infections. Several traits that may contribute to enhanced virulence have been identified in Enterococci. Extracellular surface protein (Esp) is a virulence factor that contributes in biofilm formation and resistance to environmental stresses. In this study we aimed to determine occurrence of esp in E. faecium and E. faecalis isolates isolated from urinary tract infections and to investigate whether there is any correlation between presence of esp and antibiotic resistance. One hundred and sixty six isolates were collected from patients with UTI and after identification by biochemical and PCR, antibiotic resistances were examined. The presence of esp was investigated by primer-specific PCR. 43.3% of isolates identified as E. faecium and 56.7% as E. faecalis. The esp gene was found in 76.1% of E. faecium isolates and 77.9% of E. faecalis isolate. There were significant correlation between esp positive E. faecium and resistance to Vancomycin (p<0.01), also in E.faecalis we found correlation between esp positive and resistance to Ampicillin, Chloramphenicol and Tetracycline (p<0.01, p<0.01, p<0.01 respectively). Occurrence of esp in our isolates from urinary tract infection was high that indicates importance of this gene in urinary tract infections and shows importance of ability to forming biofilm and hydrophobicity of surface of Enterococci for causing urinary infection by Enterococci. Also, our finding showed significant correlation between resistance to antibiotics and presence of esp in Enterococci.

Multidrug resistant bacterial isolates causing nosocomial urinary tract infection in a tertiary care hospital, Nepal

Nosocomial infection is becoming a leading problem in medical practitioners now-a-days placing an extra burden on individual patients worldwide. Nosocomial urinary tract infection caused by multidrug resistant (MDR) pathogens is a major threat of the patients in developing country which are increasing numbers in Nepal.

Multidrug Resistant in Nosocomial Urinary Tract Infections at a Tertiary Care Hospital in Kerala, India

Background: Nosocomial UTI (NUTI) is a major cause of morbidity in hospitalized patients and presence of urinary catheter is its single most important predisposing factor. Antibiotic resistance is a problem in these infections.

The Difference of Nosocomial Urinary Tract Infection Risk Based on Chateterization Urine, Age, and Diabetes Mellitus

Nosocomial urinary tract infection is common occurs in patients with indwelling urinary chateter. Factors that caused nosocomial urinary tract infection are host, agent, and chateterization urine. The aim of this research was to analyze risk difference nosocomial urinary tract infection based on chateterization urine, age, and diabetes mellitus (DM). This study used case control with sample size 20 for each group. Case sample was patients who diagnosed urinary tract infection, while control sampel was patients who not diagnosed urinary tract infection in Haji Hospital Surabaya on 2013 until 2014. The independent variables were duration of chateterization, frequency of chateterization, age, and DM, while dependent variable was nosocomial urinary tract infection. Those variables was analyze with risk difference (RD) in Epi Info. The result showed that risk difference nosocomial urinary tract infection based on duration of chateterization is RD = 0,52 it means if changing chateter was done every seven days used, it can prevent 0,52 from 0,71 or 73,53% urinary tract infection cases, frequency of chateterization is RD = 0,43956 it means if decrease frequency of chateterization until one time used, it can prevent 0,44 from 0,79 or 55,94% urinary tract infection cases, age is RD = 0,40 it means if insertion of urine catheter as indicated and right procedure in patient with &gt;55 old it can prevent 0,40 from 0,68 or 59,26% urinary tract infection cases, and DM is RD = 0,42 it means if preventing toward DM, it can prevent 0,42 from 0,75 or 55,56% urinary tract infection cases.Keyword: chateterization urine, age, diabetes mellitus, nosocomial urinary tract infection

The Difference of Nosocomial Urinary Tract Infection Risk Based on Chateterization Urine, Age, and Diabetes Mellitus

ABSTRACTNosocomial urinary tract infection is common occurs in patients with indwelling urinary chateter. Factors that caused nosocomial urinary tract infection are host, agent, and chateterization urine. The aim of this research was to analyze risk difference nosocomial urinary tract infection based on chateterization urine, age, and diabetes mellitus (DM). This study used case control with sample size 20 for each group. Case sample was patients who diagnosed urinary tract infection, while control sampel was patients who not diagnosed urinary tract infection in Haji Hospital Surabaya on 2013 until 2014. The independent variables were duration of chateterization, frequency of chateterization, age, and DM, while dependent variable was nosocomial urinary tract infection. Those variables was analyze with risk difference (RD) in Epi Info. The result showed that risk difference nosocomial urinary tract infection based on duration of chateterization is RD = 0,52 it means if changing chateter was done every seven days used, it can prevent 0,52 from 0,71 or 73,53% urinary tract infection cases, frequency of chateterization is RD = 0,43956 it means if decrease frequency of chateterization until one time used, it can prevent 0,44 from 0,79 or 55,94% urinary tract infection cases, age is RD = 0,40 it means if insertion of urine catheter as indicated and right procedure in patient with &gt;55 old it can prevent 0,40 from 0,68 or 59,26% urinary tract infection cases, and DM is RD = 0,42 it means if preventing toward DM, it can prevent 0,42 from 0,75 or 55,56% urinary tract infection cases.Keyword: chateterization urine, age, diabetes mellitus, nosocomial urinary tract infection

Assessment of nosocomial urinary tract infections in diabetic patients at a University Hospital in Turkey

Assessment of nosocomial urinary tract infections in diabetic patients at a University Hospital in Turkey

Novel low-resource intervention reduces urinary catheter use and associated urinary tract infections: Role of outcome measure bias?

Previous interventions targeting nosocomial urinary tract infections have reduced catheterization and infections, but they require significant resources and may be susceptible to misclassification and surveillance bias. We sought to determine the effectiveness of a novel intervention at reducing catheterization and infections while exploring the potential for bias. We conducted a prospective study of a brief monthly in-person educational intervention focusing on appropriate urinary catheter use. We studied 1,335 patients (13,753 patient days) on 1 control and 1 intervention ward. After the intervention, the device utilization rate was significantly reduced, with a relative risk of 0.49 (95% confidence interval [CI], 0.32-0.76; P = .001) versus 1.02 (95% CI, 0.58-1.82; P = .93) for controls. Both wards demonstrated a reduction in catheter-associated infections after intervention, with an intervention relative risk of 0.42 (95% CI, 0.16-1.08; P = .07) and 0.51 (95% CI, 0.22-1.20; P = .12) for controls. There was no change in the rate of all nosocomial urine infections, with an intervention relative risk of 0.79 (95% CI, 0.38-1.65; P = .53) and 0.89 (95% CI, 0.48-1.67; P = .72) for controls. Our study demonstrates that our novel educational intervention significantly reduces urinary catheter use in hospitalized patients. The trend towards reduced catheter-associated infections after intervention, coupled with the absence of an improvement in all nosocomial infections supports a potential role of misclassification bias. We suggest that future prospective investigations explore this phenomenon using more robust outcome measures.

Inhibition of quorum sensing mediated biofilm development and virulence in uropathogens by Hyptis suaveolens

Bacterial urinary tract infections (UTIs) are the most common nosocomial infections, accounting for about 40% of all hospital-acquired infections. The bacterial spectrum of nosocomial UTIs is broad and the treatment of UTIs is becoming difficult owing to the emergence of drug resistance. Therefore, it is reasonable to investigate novel and alternative therapeutic strategies to treat UTIs. Since UTIs are caused by uropathogens with quorum sensing (QS)-dependent biofilm forming abilities, interruption of QS systems may be a novel approach to combat drug resistance. In the present study, a methanol extract (and hexane extract derived from it) of the medicinal plant Hyptis suaveolens (L.) were shown to have anti-QS activity against the biosensor strain Chromobacterium violaceum (ATCC 12472). Furthermore, the hexane extract of H. suaveolens (HEHS) inhibited biofilm formation by uropathogens such as Escherichia coli, Proteus vulgaris, Proteus mirabilis, Klebsiella pneumoniae and Serratia marcescens. HEHS promotes the loosening of biofilm architecture and strongly inhibits in vitro biofilm formation by uropathogens, which was more apparent from microscopic images. In addition to this, HEHS reduces the production of QS-dependent virulence factors like protease and hemolysin, along with motility. The partial purification and GC-MS analysis of the active fraction revealed the presence of several therapeutically important compounds which may synergistically act on the uropathogens and possibly reduce the QS-dependent phenotypes. These findings suggest HEHS as potential phytotherapeutic agent which can be employed to formulate protective strategies against biofilm linked infections caused by uropathogens.

Urinary tract infections in newborns

The incidence of neonatal urinary tract infection (UTI) varies from 0.1 to 1% of all infants, and its frequency is inversely proportional to birth weight [1]. Neonatal UTI presents different features than those observed in other age groups for several reasons, including higher prevalence, male sex predominance, and most importantly higher risk of urosepsis [2]. As the symptoms of a UTI in a neonate, such as irritability, poor feeding and vomiting are generalized, the clinician should have a high index of suspicion. The best correlates of infection in infants with UTI were found to be a body temperature greater than 38 o C and uncircumcised males [3]. Escherichia coli is the most likely pathogen, but Klebsiella pneumoniae, Enterobacter spp., Enterococcus spp., Pseudomonas spp., Candida spp. and coagulase-negative staphylococci have to be considered in nosocomial UTI as well [1-3]. A positive blood culture is reported in 12.4% of cases, and nosocomial UTI is nearly twice likely to result in urosepsis compared with community-acquired UTI [2]. Bladder puncture or transurethral catheter is recommended for urine sampling in neonates to avoid urinary contamination. Parenteral antibiotic regimen, including a combination of a third-generation cephalosporin or aminoglycoside with ampicillin for a total of 7-14 days should be commenced urgently in the suspicion of pyelonephritis following urine sampling for culture. Vancomycin and an aminoglycoside should be considered for nosocomial UTI. In the light of the results of sensitivity testing, a single-antibiotic coverage, if possible, should be considered [1-3]. The presence of high-grade reflux, severe urinary obstruction, and recurrent pyelonephritis mandates antibacterial prophylaxis, however its efficiency has not yet been proven [2]. Radiological studies have to be undertaken once a diagnosis of UTI has been made. An abnormal renal ultrasound is reported in around one third of cases, and vesicoureteral reflux is observed in nearly one fourth during voiding cystourethrogram (VCUG). The urine should be sterile while performing a VCUG [2, 3]. Gram-negative antibiotic resistance is emerging worldwide and outbreaks have occurred in neonatal units due to multi-resistant gram-negative bacteria [4]. To overcome this problem in the case of a UTI, urine cultures should be appropriately obtained, and the treatment should be tailored based on sensitivity results; antibiotic prophylaxis should be spared to aforementioned high-risk groups, while emphasizing the importance of compliance; and pediatric-specific antibiograms should be used [5]. Finally, evidence-based guidelines for the diagnosis and management of UTI in febrile infants aged less than 2 months are lacking, and urgently required [2].

Antibiotic resistance pattern of Enterococci isolates from nosocomial infections in a tertiary care hospital in Eastern India.

Background:Resistance to commonly used antibiotics by Enterococci causing nosocomial infections is of concern, which necessitates judicious, responsible and evidence-based use of antibiotics. The present study was conducted to review the prevalence and identify therapeutic options for nosocomial Enterococcal infections in our tertiary care hospital.Materials and Methods:Isolates identified by morphological and biochemical characteristics were tested for antibiotic susceptibility using Kirby-Bauer method.Result:153 of 2096 culture positive clinical samples comprised of 101 urine, 30 wound swab/pus, 13 blood and 09 high vaginal swab isolates were identified as Enterococcus faecalis (90.85%), Enterococcus faecium (8.50%) and Enterococcus gallinarum (0.65%). Enterococci accounted for 8.45%, 4.53%, 4.23%, 4.43% of urinary, wound swab or pus, blood, high vaginal swab isolates respectively, causing 7.3% of all nosocomial infections. Significant number of Enterococci isolated from nosocomial urinary tract infection (66.01%) and wound infections (19.6%) were multidrug resistant (MDR). Although all isolates were sensitive to vancomycin and linezolid, resistance to erythromycin (71.24%) and ciprofloxacin (49.67%) was frequently observed. High-level gentamicin resistance was observed in 43.88%, and 61.53% of E. faecalis and E. faecium isolates respectively. Minimal inhibitory concentration of vancomycin of all the isolates were ≤1 μg/ml. 7% of the Enterococcal isolates were MDR strains and vancomycin or linezolid were the only effective antibiotics.Conclusion:A combination of vancomycin and/or linezolid were effective against Enterococci causing nosocomial infections in our tertiary care facility, nevertheless continuous and frequent surveillance for resistance patterns are necessary for judicious and evidence based use of antibiotics.

Candiduria in Catheter Associated Urinary Tract Infection with Special Reference to Biofilm Production

Urinary tract infections as a result of Candida species are becoming increasingly common in hospital settings. The association is higher in patients with prolonged urinary catheterization and also various pre-disposing factors. This study was done to look into the significance of candiduria in the catheterized patients and to perform microbial catheterization of yeast and biofilm detection by tube method to guide treatment protocol. This is a prospective study. One hundred urine samples were collected over a period of 3 months. Specimens included were those of patients presenting with nosocomial Urinary tract infection (UTI) after 72 hours of hospitalization. The urine samples obtained were immediately processed in microbiology laboratory by semi-quantitative method as per standard protocol. All yeast isolates were stored for further microbial characterization. Biofilm production was detected by tube method. In the present study we observed that out of 100 samples obtained from catheterized patients presenting with nosocomial UTI 26% were caused by Candida species. Among the 26 Candida isolates 16 (61.53%) were non albicans Candida and 10(38.47%) were Candida albicans. Out 26 Candida isolates, 14(53.84%) of the candida isolates were found to produce biofilm. Biofilm production was found to occur more frequently among non albicans Candida 10(62.5%) than Candida albicans 4(40.0%). The present study reiterates the presence of candiduria in catheterized patients. Non-albicans candida speices are replacing candida albicans as the predominant pathogen for nosocomial UTI. It was also observed that Biofilm formation is seen more frequently with non albicans candida species than with Candida albicans.

Prevalence of Plasmid-Mediated Quinolone Resistance Determinants and OqxAB Efflux Pumps among Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae Isolated from Patients with Nosocomial Urinary Tract Infection in Tehran, Iran.

Objective. Plasmid-mediated quinolone resistance (PMQR) plays an important role in the development of clinical resistance to quinolone. The aim of this study was to investigate PMQR determinants among extended-spectrum β-lactamases- (ESBL-) producing Klebsiella pneumoniae recovered from patients with nosocomial urinary tract infection (UTI). Methods. A total of 247 ESBL-producing K. pneumoniae isolates were collected from 750 patients with UTI. ESBL production was confirmed by double disc synergy test and combined disc diffusion test. The prevalence of PMQR determinants among ESBL-producing K. pneumoniae was assessed using PCR method. Results. The rates of resistance to antimicrobial agents in present study varied from 14.2% to 98.8%. In comparison with other PMQR genotypes, the frequency of aac(6′)-Ib (68.8%) was strikingly high. Of the 247 isolates tested, qnrA, qnrB, qnrS, and qepA genes were present in 3.6%, 1.6%, 1.2, and 2%, respectively. oqxA and oqxB were detected in 56.7% and 54.6% of isolates. The predominant coexisting ESBL and PMQR profile among our isolates included bla CTX-M and aac(6′)-Ib, oqxA, oqxB (28.3%) and bla TEM, bla SHV and aac(6′)-Ib, oqxA, and oqxB (19.4%) profile. Conclusion. Given the linkage observed between resistance to quinolones and beta lactam antibiotics, therapeutic protocol with fluoroquinolones and beta lactam antibiotics should be seriously revised in Tehran hospitals.

Incidence of β-lactamases Among Novel Multidrug Resistant Clinical Isolates of UTI Patients: An Antimicrobial Resistance Surveillance Study

Community or Nosocomial Urinary Tract Infections (UTI) are increasing worldwide speedily by creating problem to currently available β-lactam antibiotic therapies. Thus it is an urgent need of research to find the effective therapeutic options to treat / manage the UTI. Therefore, the present work is designed to determine prevalence of β-lactam resistance in seven novel bacterial isolates from the community UTI as well as to identify and characterize the types of β-lactamases involved in UTI. Total Five Hundred and Forty Nine (n= 549) clinical strains isolated from Urine samples and identified as E. coli, P. mirabilis, K. pneumoniae, P. aeruginosa, Enterobacter spp., Escherichia spp., Enterococcus spp., A. haemolyticus, Micrococcus, Serratia spp., Shigella spp., Staph. Aureus etc. Antimicrobial susceptibility profile of these strains revealed high level resistance to Ampicillin (99%), Ceftazidime (98.99%), Amoxicillin (98%), Cefotaxime (99%), Cefaclor (98%) and Penicillin (99%). Thus out of 549 only seven were detected as novel Extended Spectrum β-lactamase producers. All the seven isolates were identified at 16 S r RNA level and submitted to NCBI with following accession numbers such as: JX827388.1, JX827385, JX827384.1, JX827383.1, JX827382, JX827386 and JX827387. Minimum inhibitory concentration of each novel strain was determined against 25 different β-lactam antibiotics i.e. Ampicillin, Amoxiclav, Oxacillin, Vancomycin, Gentamycin, Ciprofloxacin, Nitrofurantoin, Ceftazidime, Cotrimaxazole, Trimethoprim, Imipenam, Amikacin, Amoxicillin, Cephalexin, Cefuroxime, Nalidixic acid, Cefazoline, Cefdinir, Cefexime, Ceftriaxone, Cefuroxime, Cefotaxime, Aztreonam, Cefaclor, Penicillin etc. All these strains revealed to possess virulence markers such as α-hemolysin, Cell surface hydrophobicity, Aerobactin production, Serum Resisitance, Colicine production etc. In addition to this an antimicrobial surveillance of the same strain was tested for multiple antibiotic resistance scale with the help of WHONET software designed by World Health Organization.

Molecular typing of nosocomial enterococci by pulsed-field gel electrophoresis

Objective: Enterococci are the second most common cause of nosocomial urinary tract and wound infections, also third most common cause of nosocomial bacteremia. Currently, especially vancomycin-resistant enterococci (VRE) are one of the significant pathogens that cause nosocomial infections and increase mortality, morbidity, and healthcare costs. Therefore prevention and control of the nosocomial VRE outbreaks and epidemiological analysis of the infection are important. Pulsed-Field Gel Electrophoresis (PFGE) is accepted as a “gold standard” method in the molecular epidemiological analysis of enterococcal infections. The aims of this study are to determine the clonal relationship among the nosocomial enterococcal isolates and the rate of cross-contamination between them. Method: Thirty-six Enterococcus strains isolated from hospitalized patients with nosocomial infection in different clinics of Dicle University Hospital between November 2010 and June 2012 were included in this study. A total of 36 isolates were obtained from various clinical samples including urine (n=18), blood (n=6), bronchoalveolar lavage (BAL) fluid (n=5), wound biopsy sample (n=5), vaginal smear (n=1) and catheter tip (n=1). Nine of the thirty-six isolates were VRE. Isolation and identification of the isolates were conducted in the OZET Amac: Enterokoklar hastaneden kaynaklanan uriner