Resistance Patterns Of Uropathogens Research Articles

Antibiotic Resistance Pattern Among Isolated Bacteria from Urinary Tract Infection Patients in the Intensive Care Unit

Background: Urinary tract infection (UTI) is one of the most important health care issues with a major role in occurrence of nosocomial infections. Rise in antibiotic resistance rate by UTIs not only lead to morbidity and mortality, but also impose a remarkable financial burden on health care infrastructure. This study was undertaken to evaluate the prevalence of UTIs and identify common microorganisms responsible for infection and their antibiotic resistance profile in our Intensive Care Unit (ICU).
 Methods: In this perspective cross-sectional study, data from patients admitted to the ICU of two main referral hospitals in Yasouj, Southern-west Iran from 2015- 2016 was collected. Patients were selected in a subsequent manner and were asked to provide a midstream urine sample. Positive cultures were subsequently placed in differential culture medium for the diagnosis of the causative pathogen, while also evaluating with Muller Hinton Agar culture for antibiogram through disc diffusion method, to evaluate the pathogens sensitivity and resistance towards the tested antibiotics.
 Results: Based on bacterial culture results among a total of 112 obtained urine samples, 100 (89.2%) were negative while 12 (10.8%) were positive, in which the majority were gram-negative (6.25%) and the most frequent pathogen was Escherichia coli (5.3%). All cases of UTI in our population were fully resistant to cephalexin, ampicillin, and amoxicillin. Also, all gram-negative cultures were sensitive to amikacin. There was also no significant association between the antibiogram results with age, gender, and gram results.
 Conclusion: we report actual data on the resistance patterns of uro-pathogens in a public hospital in Iran. Escherichia coli showed a high prevalence among all UTIs with lower resistance rates to the antibiotics. Resistance to nalidixic acid and trimethoprim-sulfamethoxazole were significantly lower than other oral antibiotics, making both a suitable and cheap alternative for the empirical treatment.

Prevalence and Resistance Pattern of Uropathogens in Pregnant Women- A Cross-Sectional Study

Introduction: Urinary Tract Infection (UTI) is the most common medical problems associated with pregnancy occurring in about 5-10% of pregnant women. It is attributed by various micro- organisms. As the uropathogens is usually Multidrug resistance so, timely identification of these uropathogens and their resistance pattern detection is essential. If UTI is not treated promptly, it can lead to various complications and ultimately can affect health of infant or the pregnant mother. Aim: To estimate the frequency of UTI and different micro- organisms in pregnant women as well as their antibiotic resistant pattern among them. Materials and Methods: Present study was conducted in a tertiary care hospital in rural district of Chhattisgarh. During the study period from August 2021 to October 2021, 130 urine samples were collected and processed as per standard protocol. With significant growth on culture ≥105 Colony Forming Unit (CFU)/mL of single morphotype bacteria from a clean catch midstream urine sample UTI diagnosis was established. The bacteria isolated were identified up to species level by standard biochemical tests. Results: In this study, UTI was found in n=69.2% of pregnant women. The most frequently isolated organism was E. coli (53.3%), followed by Klebsiella spp.(18.9%) and Pseudomonas spp. (3.3%). Highest prevalence rate (85.7%) was observed in the age group 21 to 25 years; most of these (77.8%) were in their 2nd trimester. The isolated pathogens mostly showed multiple drug resistance to two or more antibacterial agents tested. Conclusion: There was higher incidence of UTI in pregnancy and the most predominant organism isolated was E. coli; in 2nd trimester UTI was more common and high level of multidrug resistance was observed. In pregnancy, continuous monitoring of uropathogens including their resistance pattern is required.

Prevalence and resistance pattern of uropathogens from community settings of different regions: an experience from India.

IntroductionUrinary tract infection (UTI) is one of the most common infections in clinical practice worldwide in both healthcare and community settings causing significant morbidity and mortality. It is one of the major conditions at the community level treated empirically and regarded as a potential cause of emergence of antimicrobial resistance (AMR). Limited information is available regarding community-acquired UTI (CA-UTI) from India.MethodologyThis is a first of its kind, multicentric-cross-sectional study at the community level targeting patients attending the out-patient department (OPD) of the community health centre (CHC) from four geographical regions (North, South, West and East) of India. The study had been designed to determine the epidemiology, antibiogram profile and identification of extended-spectrum beta-lactamase (ESBL) producer and carbapenem resistant (CR) uropathogens. Samples were collected prospectively from UTI suspected patients coming at CHC and processed at the tertiary healthcare centres using a common standard operating procedure. Clinical history of all the patients exhibiting significant bacteriuria was collected and data was analysed.ResultOverall, 250 out of a total of 2459 (10.1 %) urine samples were positive for bacteria with significant bacteriuria (adult: paediatrics, 6.7 : 1). Females were predominantly affected (male: female, 1 : 2.9). History of recent episode of UTI was observed as the commonest risk factor followed by diabetes mellitus. Altogether, 86 % of total cases were caused by Escherichia coli (68 %) and Klebsiella pneumoniae (17.6 %) together. Among the commonly used oral antibiotics for the Gram-negative bacilli (GNB), the highest resistance was observed against beta-lactams, first- and second-generation cephalosporins, fluoroquinolones and co-trimoxazole. Overall, the prevalence of ESBL producer and CR isolates were 44.8, and 4.3 %, respectively. However, the ESBL production, CR and nitrofurantoin resistance among the uropathogenic E. coli (UPEC) isolates was 52.8, 5.1 and 14 %, respectively. No resistance was found against fosfomycin among the UPEC isolates.ConclusionThe current study highlights the increasing incidence of AMR among uropathogens at the community-settings of India. A significant percentage of ESBL producers among the isolated UPEC and K. pneumoniae were observed. The currently available evidence supports the clinical recommendation of fosfomycin and nitrofurantoin for empiric therapy in CA-UTI in India.

Antibiotic Resistance Pattern of Uropathogens among Non Pregnant Women: A Hospital based Cross Sectional Study from Odisha

Urinary tract infection (UTI) is one of the most delicate health problem affecting women with severe complications and the rising antimicrobial resistance exerts a massive influence in treating UTIs. The objectives of this study was to identify the uropathogens causing UTI in non-pregnant women and their antibiotic resistance pattern. The study was undertaken in the outpatient department (OPD) of Obstetrics and Gynaecology, Capital Hospital, Bhubaneswar, Odisha during April 2015 to March 2016. A total of 766 midstream urine samples (MSU) was collected from women of different age. Out of 766 urine samples, 323 (42.1%) samples were culture positive for UTI with prominent bacteriuria. E.coli was found to be the most common isolate (54.79 %) followed by Staphylococcus sp. (22.6%), Enterobacter sp. (17.64%) and Klebsiella sp. (4.95%). Amongst various clinical symptoms, burning and itching during urination was found to be the most common (69.97%) symptoms followed by abnormal discharge of the vagina (45.20%) and the presence of cloudy urine (24.46%). E.coli the most predominant uropathogen identified was found to be highly susceptible towards a low level of resistance towards nitrofurantoin (11.8%) followed by amikacin (20.03%) and gentamicin (22.0%). Our study revealed that E. coli isolates were the predominant uropathogens and showed escalating model of resistance to the general available antimicrobial agents which are frequently used by the physicians in hospitals and private practice.

CHILDHOOD URINARY TRACT INFECTION: CLINICAL SIGNS, BACTERIAL CAUSES AND ANTIBIOTIC SUSCEPTIBILITY

Background and objective: Urinary tract infections (UTIs) are the neglected infection in children from the side of study its clinical symptoms, causative organisms and their antibiotic sensitivity. This investigation searches for determine clinical symptoms frequency, prevalence rate, bacterial features, and antibiotic sensitivity of bacterial urinary tract infection in children attending private children’s health center in Sana’a city. Methods: In a prospective study carried out over a 24-month period, 1925 samples from children patients suspected of having a UTI were investigated, of which 175 were culture-positive. Clinical and demographic data were collected. Isolated bacteria were identified by standard tests, and antibiotic susceptibility was performed by the disk diffusion method. Results: Fever was the most frequent symptom that occurred (88%) while other UTI symptoms were less frequent than that reported in adult patients for UTI. The most common etiological agent was Escherichia coli (89.7%), followed Staphylococcus aureus (3.4%), Klebsiella spp (2.9%), Proteus spp (2.3%), and beta haemolytic streptococci (1.7%). Results of antimicrobial resistant for E. coli, as the most prevalent cause of UTI, to commonly used antibiotics are ranged from less than 3% for levofloxacin, gentamicin, amikacin and cefoxitin to more than 75% for tetracycline, nalidixic acid, doxycycline, co-trimoxazol and amoxicillin . Conclusions: The results show the most common symptom of UTI are fever and lack of more obvious symptoms of UTI in adult patients. The antimicrobial resistance patterns of the causes of UTI are highly changeable and constant surveillance of trends in resistance patterns of uropathogens among children is essential. Peer Review History: Received: 11 July 2021; Revised: 13 August; Accepted: 5 September, Available online: 15 September 2021 Academic Editor: Ahmad Najib, Universitas Muslim Indonesia, Makassar, Indonesia, ahmad.najib@umi.ac.id UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Nuray Arı, Ankara University, Turkiye, ari@ankara.edu.tr Dr. Salfarina Ramli, Department of Pharmacology and Pharmaceutical Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia. salfarina2892@uitm.edu.my Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, edress2020@gmail.com Dr. Asia Selman Abdullah, University of Basrah, Iraq, asia_abdullah65@yahoo.com Similar Articles: URINARY TRACT INFECTIONS IN POST OPERATIVE PATIENTS: PREVALENCE RATE, BACTERIAL PROFILE, ANTIBIOTIC SENSITIVITY AND SPECIFIC RISK FACTORS BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN

A retrospective study of Antimicrobial resistance pattern of uropathogens in a Tertiary Care Hospital in Upper Assam

A retrospective study of Antimicrobial resistance pattern of uropathogens in a Tertiary Care Hospital in Upper Assam

Prevalence of urinary tract infections, associated risk factors, and antibiotic resistance pattern of uropathogens in young women at Noakhali, Bangladesh

Urinary tract infection (UTI) remains one of the most common infections among young females diagnosed in developing countries. The emergence of antibiotic resistance among uropathogens is a global problem. This study aimed to determine the prevalence and resistance of antibiotics to uropathogens, and to understand the relationship of uropathogens to multiple clinical, social and demographic factors of young female students in a university in Bangladesh. Four hundred freshly voided midstream urine samples collected from young female students and several clinical and socio-demographic variables along with UTI symptomatic queries were determined. Bacterial isolation was carried out by using standard and specific microbiological techniques and antimicrobial susceptibility pattern was determined by Kirby Bauer Disc diffusion method. Among the tested specimens, 106 (26.5%) has significant bacterial growth, 60 (57%) were symptomatic, and 46 (43%) were asymptomatic. The highest uropathogen was recorded within the age group of 24-25 years (51%). There was a significant association (p < 0.05) of uropathogen with anatomical abnormality of urinary tract, water sources for food preparation and bathing, and the number of person sharing the same toilet. Most predominantly isolated bacteria were E. coli (32.08%) followed by Staphylococcus saprophyticus (24.53%), Streptococcus spp. (16.04%), Klebsiella spp. (14.15%), Aceinetobacter spp. (4.72%), Citrobacter spp. (2.83%), Enterobacter spp. (2.83%), and Pseudomonas spp. (2.83%). In the effectiveness of each treated antibiotic, urinary pathogens were highly resistant towards nalidixic acid (80.19%), ampicillin (75.73%), cephalexin (70%) and azithromycin (68.48) while against imipenem (7.94%) and amikacin (18.87%) least resistancy were found. A good understanding of the etiology of uropathogens will assist the general practitioner to identify the correct therapeutic strategy for the proper management of UTIs. Asian J. Med. Biol. Res. 2021, 7 (2), 202-213

Childhood Urinary Tract Infection: Prevalence and Resistance Pattern of Uropathogens in a Tertiary Care Hospital

Childhood Urinary Tract Infection: Prevalence and Resistance Pattern of Uropathogens in a Tertiary Care Hospital

Spectrum and Antibiotic Resistance Pattern of Uropathogens Causing Urinary Tract Infection Among Inpatients and Outpatients: An Experience of a Tertiary Care Hospital in Karachi, Pakistan

Objective: To determine the spectrum and antibiotic resistance pattern of uropathogens causing urinary tract infection among inpatients and outpatients in a tertiary care hospital in Karachi Methods: This descriptive cross-sectional study was conducted in the Department of Microbiology, Sindh Institute of Urology and Transplant, Karachi, The study was conducted from March 2016 to March 2017 after taking approval from the Hospital Ethics Committee. Urine specimens were analyzed to establish a diagnosis of UTI and identify uropahtogens. The antibiotic susceptibility pattern of uropathogens was studied using disc diffusion method against the following antibiotics; fosfomycin, ampicillin, amoxicillin-clavulanate, nitrofurantoin, cefotaxime, ceftazidime, amikacin, cefoxitin, imipenem and vancomycin. Results: A total of 480 samples of UTI were received during the study period. The average age of patients was 54.79±12.09 years. The majority of samples came out positive from the male gender (65%) and in-patient department (n=400, 83.3%). The highest prevalent microorganism was E.coli (82.1%) followed by Klebsiella spp (14%), Pseudomonas aeruginosa (1%), Proteus mirabilis (1%), Morganella morgannii (1%) and Staphylococcus aureus (0.8%). All microorganisms were highly resistant to augmentin, cefoxitin, cefotaxime, ceftazidime. Only pseudomonas aeruginosa was highly resistant to imipenem (60%). Pseudomonas aeruginosa (100%), E.coli (86.8%) and Klebsiella spp (71.6%) were highly sensitive for Amikacin (100%). Morganella morgannii (80%) and Proteus Mirabilis (40%) were mainly resistant to Fosfomycin. Only E.coli was sensitive to nitrofurantoin (74.1%). Conclusion: The presented study demonstrated that gram-negative bacteria was the most frequent cause of urinary tract infection. Microorganisms showed variable resistance to different antibiotics. The first line of antibiotics should be rationally selected by physicians to treat urinary tract infections.

Prevalence and Antimicrobial Resistance Patterns of Uropathogens Isolated from Urinary Tract Infections

Prevalence and Antimicrobial Resistance Patterns of Uropathogens Isolated from Urinary Tract Infections

Antibiotic resistance pattern of uropathogens in patients with urinary tract infection in a tertiary care center, Karnataka

Antibiotic resistance pattern of uropathogens in patients with urinary tract infection in a tertiary care center, Karnataka

Prevalence of Multidrug-Resistant, Extensively Drug-Resistantand Pandrug-Resistant Uropathogens Isolated From UrinaryTract Infection Cases in Dhaka, Bangladesh

Background: The resistance pattern of uropathogens is increasing very rapidly because of the unsorted, insufficient, and incoherent usage of antibiotics. The aim of this study was to evaluate the prevalence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) uropathogens which were isolated from the urinary tract infection (UTI) cases in Dhaka, Bangladesh. Methods: In this cross-sectional study, a total of 21167 urine samples were collected from January 2016 to December 2018, followed by using conventional methods, as well as Kirby-Bauer disc diffusion method for urine culture and susceptibility, respectively. Finally, SPSS software was utilized to analyze the obtained data. Results: From among 21167 urine samples, 2469 (11.66%) cases were bacteriologically positive. In UTI cases, males proportion were higher compared to females (in ≤ 10 and > 60 to ≤90 years age groups) and females in the age groups between 10 and 60 and >90 years suffered more than males (P<0.05). In addition, 172 (7.0%), 1337 (54.2%), and 845 (34.2%) cases were identified as XDR, single drug-resistance (SDR), and nondrug-resistance (NDR), respectively. Although the number of female XDR cases was higher than males, the percentages of male cases were higher compared to female cases in this study. The most predominant drugresistance cases (18.7%) were found in the age group between 21 and 30 years (P<0.05). Eventually, the isolates of Escherichia coli were the most prevalent cases that carried XDR (5.4%) and MDR (39.7%). Conclusions: In general, it is extremely alarming to increase XDR and MDR uropathogens. This bacterial resistance can be prevented through control measures that limit the spread of resistant bacteria and the regular monitoring of this resistance phenotype of uropathogens, along with the rational use of antimicrobial therapy.

Community-acquired urinary tract infections in children: Resistance patterns of uropathogens in a tertiary care center in Saudi Arabia.

ObjectiveThe aim of the present study was to investigate the bacterial pathogens and their resistance patterns in children presenting with their first admission for a urinary tract infection (UTI) in a large tertiary care center in Riyadh, Saudi Arabia.MethodsA retrospective chart review was conducted of pediatric patients 0–14 years of age who were admitted for their first community-acquired UTI in a large tertiary care center in Riyadh, Saudi Arabia. The review covered a 6-year period (2006–2012).ResultsData were obtained from 202 children, of which 162 (80.2%) were female. The most frequently isolated uropathogens were Escherichia coli (75.7%), followed by Klebsiella pneumoniae (9.4%), Pseudomonas aeruginosa (5.9%) and Enterococcus species (3.5%). Sixteen (7.9%) isolates were ESBLs. Among all uropathogens, 68% were resistant to ampicillin, 54% resistant to co-trimoxazole, and 30% resistant/intermediate sensitivity to amoxicillin/clavulinic acid. Overall, there was a low resistance rate to cefotaxime (4.4%).ConclusionE. coli is the predominant uropathogen causing UTIs in children, yet there is a high rate of multidrug-resistant organisms. For children admitted for a community-acquired UTI, a third-generation cephalosporin remains an appropriate empiric antibiotic. Our study and the work of others emphasize the importance of choosing empiric antibiotics for pediatric UTIs based on local resistance patterns.

Antimicrobial Pharmacotherapy Management of Urinary Tract Infections in Pediatric Patients.

Objective: To discuss the risk factors, microbial resistance rates, and pharmacotherapy, including antimicrobial choices and medication dosage regimens, for urinary tract infections (UTIs) in pediatric patients. Data Sources: A MEDLINE literature search (1985 to December 2017) was performed using the following keywords and associated medical subject headings: urinary tract infection, antimicrobial, treatment, and children. Study Selection and Data Extraction: Search was conducted to identify clinical trials, systematic reviews, and guidelines. Search was filtered to include studies with age range between birth and 18 years and published in English. Additional references were identified from selected review articles. Data Synthesis: In total, 27 studies investigating microbial resistance, 31 studies assessing antimicrobial efficacy, 34 studies describing prophylaxis, and 6 systematic reviews were included. The resistance patterns differed across age groups and affected the choice of empirical therapy. If pyelonephritis is suspected, empiric antimicrobials should have high urinary and sufficient parenchymal concentrations. Nitrofurantoin has low microbial resistance rates and can generally be used empirically for treating uncomplicated cystitis in children >1 month of age. Trimethoprim-sulfamethoxazole resistance has increased and should be avoided unless local susceptibility data are available. Certain patients with recurrent UTIs or renal abnormalities may require antimicrobial prophylaxis, which may be associated with adverse effects, such as intolerability or an increased risk of microbial resistance. Conclusion: The resistance pattern of uropathogens should be considered prior to initiating therapy. Controlled trials with large samples are needed to compare the treatment duration of various antimicrobial regimens and the specific role of prophylactic antimicrobials.

Changing Trends in Antibiotic Resistance Pattern of Uropathogens with Reference to Nitrofurantoin, Quinolones, Aminoglycosides and Carbapenems in a Tertiary Care Hospital

Changing Trends in Antibiotic Resistance Pattern of Uropathogens with Reference to Nitrofurantoin, Quinolones, Aminoglycosides and Carbapenems in a Tertiary Care Hospital

Antimicrobial Resistance in Uropathogen Isolates from Patients with Urinary Tract Infections

Aims: Because of uncontrolled and widespread use of antibiotics, the resistance pattern of uropathogens is changing drastically, specifically in developing countries, such as Bangladesh. The aim of the study was to identify the common Urinary Tract Infection (UTI) causing pathogens in the city of Jessore, Bangladesh and to check the performance of available antibiotics used by those patients. Study Design: Random 100 UTI patients who exhibited general UTI symptoms were included in our cross-sectional study. A medical proforma was prepared to input the information associated with the experiment including symptoms of patient’s age, sex, laboratory diagnosis and antimicrobial susceptibility. Place and Duration of Study: Department of Microbiology, University of Science and Technology, Jessore 7408 and Pharmacy Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh, between June 2013 and July 2014. Methodology: Urine samples from 100 suspicious urinary tract infected patients were collected as described by Thomson and Miller. Bacterial isolates were tested to identify the bacterial species and to evaluate their antimicrobial susceptibility by Kirby-Bauer disk diffusion technique against some common antibiotics. Epidata® computer program 3.1 and SPSS version 16 statistical software used for confidence interval (CI) and P value, which were defined as P value is

The Last Three Years Antibiotic Susceptibility Patterns of Uropathogens in Southwest of Iran

Background: Urinary tract infections are always treated empirically before the results of bacteriological cultures are obtained. The choice of antibiotics depends upon the causative organism and its expected local antibiotic susceptibility pattern. Objectives: We analyzed the spectrum and resistance patterns of uropathogens against common antimicrobial agents in Ahvaz Abuzar Children's Hospital, a tertiary care pediatric unit in southwest of Iran. Patients and Methods: In this retrospective study, all urine samples of children hospitalized with urinary tract infection (288 patients, aged 1mon -14.5 years) during October 2008 to May 2011 were included in the study. After bacteria were identified by standard methods, antimicrobial susceptibility testing was performed using a panel of antimicrobial agents. Results: The most of patients were girls (n = 226, 78.5%), and the median age was 13 months. The most common pathogens were Escherichia coli (84%), Klebsiella spp. (10.1%), Enterococcus spp. (2.4%), Proteus spp. (1.7%), and Pseudomonas spp. (1.7%). Overall bacterial resistance spectrum was the highest for co-trimoxazole (64.8%), followed by gentamicin (44.6%), amikacin (40.5%), nalidixic acid (37.3%), cefotaxime (28.9%), cefixime (27.5%), ceftriaxone (27.4%), and nitrofurantoin (10.2%). The female:male ratio was 2:1 (67.1% versus 32.9%) in infants aged < 1 year and 8:1 in those aged > year (89.4% vs. 10.6%). Vesicoureteral reflux and abnormal sonography findings were associated with high resistance to cefotaxime (P = 0.017), ceftriaxone (P = 0.004), nitrofurantoin (P = 0.014), and nalidixic acid (P < 0.001). Conclusions: Increasing resistance to third-generation cephalosporins changed our opinion for using them as a single empiric intravenous therapy in hospitalized and very ill patients with acute pyelonephritis; the success will be achieved by concomitant use of an aminoglycoside or using other potent antibiotics.

Multi Drug Resistant Pathogens Causing Urinary Tract Infections in Children at Kathmandu Model Hospital

Introduction: Antibiotic resistance of urinary tract pathogens has increased globally. Updated knowledge of the antibiotic resistance patterns of uropathogens in the health institutes is important for the selection of an appropriate empirical antimicrobial therapy. The aim of this study was to evaluate the multi drug resistant urinary isolates in the children from 1 to15 years and evaluate the options for empiric antibiotic therapy. Materials and Methods: The study was conducted from December 2011 to May 2012 in the Bacteriology laboratory, Kathmandu Model Hospital. Urine samples received in the laboratory were processed for routine, culture and its sensitivity. The antimicrobial susceptibility of bacterial isolates was determined following Clinical and Laboratory Standard Institute (CLSI) recommended Kirby-Bauer Disc Diffusion method. Results: Of the total 372 urine samples received in the laboratory, 60 (16.13%) showed significant growth; of which 55.0 % (33/60) were MDR isolates. Escherichia coli were the predominant isolate from urine sample. Out of 49 Escherichia coli isolates, 27 (45.0%) were Multi drug resistant. Enterococcus faecalis (N=3) was the most predominant Gram positive isolate and 66.67 % (2/3) of this organism were multi drug resistant. Among the first line drugs used against gram negative isolates, nitrofurantoin was the most effective drug followed by quinolones, while among the second line drugs; meropenem was the most effective drug followed by chloramphenicol and amikacin, whereas; nitrofurantoin (100%) was the most effective drug for Gram positive isolates followed by norfloxacin and cefotaxime. Conclusion: High percentages of multi drug resistant uropathogens were revealed in children. Nitrofurantoin was found to be the most effective drug for gram positive, gram negative and multi drug resistant isolates. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6771 J. Nepal Paediatr. SocVol.32(3) 2012 233-238

A survey on epidemiology of urinary tract infections and resistance pattern of uropathogens in an Iranian 1000-bed tertiary care hospital.

Urinary tract infections (UTIs) are one of the most common infectious diseases diagnosed in communities and hospitalized patients. The aim of this study was to determine frequency of occurrence and antimicrobial susceptibility patterns of uropathogens in Milad hospital of Tehran, Iran. In a prospective study from March to June 2009, a total of 11308 urine sample from patients admitted in Milad hospital of Tehran were analyzed. All specimens were inoculated on routine culture media. Bacterial isolates were identified by conventional bacteriological methods. Susceptibility testing was performed by standard methods as recommended by clinical laboratory standard institute. 11308 urine samples were cultured and 1020 pathogen were isolated. Escherchia coli with 620 (60.78%) isolates was the most common causative agent of UTI followed by Klebsiella pneumoniae with 115 (11.27%) isolates. Among gram positive CocciEnterococcus spp with 110 (10.78%) isolates and Staphylococcus aureus with 81 (7.94%) isolates were predominant organisms. Of 1020 patients, 227 (22.25%) were male and 793 (77.74%) were female. Of 1020 patients, 224 (21.96%) of patients were hospitalized and 796 (78.03%) were outpatients. Of 224 hospitalized patients, 85% of isolates of E. coli were resistant to ampicillin, while this figure was 90% for K. pneumoniae. Resistant to other antibiotics were also prevalent. Nitrofurantoin was the most effective antibiotics against E. coli andEnterococcus spp. In conclusion, our study revealed that bacterial resistance in uropathogens in our hospital continues to be a great problem and needs drug resistance surveillance periodically. Key words: Urinary tract infections, drug resistance.

Infecções do trato urinário em pacientes não hospitalizados: etiologia e padrão de resistência aos antimicrobianos

INTRODUÇÃO E OBJETIVO: Infecção do trato urinário (ITU) é comumente diagnosticada na prática médica, e é cada vez mais comum o isolamento de cepas resistentes em pacientes não hospitalizados. Nosso objetivo foi avaliar a frequência e a resistência dos principais uropatógenos na cidade de Presidente Prudente, SP, entre janeiro de 2006 e dezembro de 2007. MATERIAL E MÉTODOS: Nós realizamos um levantamento de dados retrospectivo sobre a etiologia e o padrão de resistência dos uropatógenos. RESULTADOS: O uropatógeno mais frequente foi E. coli (65,97%). Foi encontrada diferença significativa (p < 0,05) na prevalência de E. coli de acordo com a faixa etária. Ampicilina e nitrofurantoína apresentaram, respectivamente, menor e maior poder inibitório contra enterobactérias. Porém, 88,4% de Proteus mirabilis apresentaram resistência à nitrofurantoína, além de apresentar padrão de resistência mais amplo. As taxas de resistência à ceftriaxona sugerem produção de extended-spectrum beta-lactamases (ESBL). DISCUSSÃO: Nossos dados são semelhantes aos encontrados em outros estudos. É importante que esses dados sejam conhecidos pela comunidade médica local, bem como dados de estudos futuros que possam detectar mudanças na etiologia ou no padrão de resistência em nossa região. Esse monitoramento constitui importante ferramenta para atualização da terapêutica empírica. CONCLUSÃO: Os dados aqui relatados demonstram que a etiologia das infecções urinárias é semelhante à encontrada em outras partes do mundo. Porém, o padrão de resistência desses uropatógenos pode possuir características diferenciadas de acordo com o histórico de consumo de antimicrobianos em cada comunidade. Assim, é importante que dados epidemiológicos sejam periodicamente divulgados com a intenção de auxiliar a comunidade médica.