Urinary Tract Infection In Patients Research Articles

The appropriateness of empirical antibiotic therapy in the management of symptomatic urinary tract infection patients-a cross-sectional study in Nairobi County, Kenya.

In low- and middle-income countries, symptomatic urinary tract infection (UTI) patients are often prescribed antibiotics without microbiological confirmation. UTIs caused by antibiotic-resistant bacteria are increasingly common, and this heightens the risk of empirical treatment failure. This study evaluates the appropriateness of empirical antibiotic therapy to UTI patients in Nairobi County, Kenya. A hospital-based, cross-sectional study was conducted in Nairobi County, Kenya, amongst symptomatic adult and child patients. UTI was defined as a monoculture growth with colony counts of ≥104 cfu/mL. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method. Empirical therapy was considered appropriate if the pathogen isolated was susceptible to the prescribed antibiotic and inappropriate if the pathogen was resistant to the prescribed antibiotic. A total of 552 participants were enrolled with a median age of 29 years (interquartile range: 24-36). The majority were female, 398 (72%). Of the 552, 274 (50%) received empirical antibiotic therapy, and 95/274 (35%) were confirmed to have UTI by culture. The antibiotics most frequently prescribed were fluoroquinolones [ciprofloxacin in 80 (30%) and levofloxacin 43 (16%)], amoxicillin-clavulanic acid in 48 (18%) and nitrofurantoin in 32 (12%). Amongst the 95 patients with bacteriological confirmation of UTI, 50 (53%) received appropriate empirical antibiotic therapy, whilst for 38 (40%) participants, the therapy was inappropriate. The complexity of appropriate empirical treatment for UTIs is compounded by high levels of resistance in UTI pathogens. Antimicrobial resistance surveillance strategies that could help in designing appropriate empirical regimens in resource constrained settings should be adopted for optimal empiric therapy.

Urinary Tract Infections in Relation to Bladder Emptying in Patients with Spinal Cord Injury.

Background/Objectives: Spinal cord injuries are debilitating conditions with significant impacts on physical function and patient quality of life. The high incidence of urinary tract infections in these patients can be attributed to neurogenic bladder-a major complication of spinal cord injuries. The aim of this study is to investigate the incidence of urinary tract infections in patients with spinal cord injuries and their relation to the method of bladder emptying. Methods: A retrospective analysis on 560 patients admitted for rehabilitation at the Clinic for Rehabilitation "Dr Miroslav Zotovic" from December 2009 to January 2023 was conducted. Patients over 18 years old who were inpatients for longer than 30 days without any symptoms of urinary tract infection on admission were included. Patient demographics, injury details, and bladder emptying methods were recorded. Results: In our study, 402 (71.8%) participants developed a urinary tract infection during their rehabilitation. Urinary tract infections were significantly more common in patients with traumatic spinal cord injuries, lower ASIA scores, and thoracic-level injuries. The highest incidence of urinary tract infections was observed in intermittent self-catheterization patients (62.7%), with Escherichia coli and Proteus mirabilis being the most frequently isolated pathogens. Conclusions: The method of bladder emptying significantly impacted the incidence of urinary tract infection in patients with spinal cord injuries. Despite guidelines favoring intermittent catheterization, this study found it to be associated with the highest infection rates. These findings suggest a need for personalized bladder management strategies to reduce the risk of urinary tract infections and improve outcomes for spinal cord injury patients.

Risk of emergency hospital admission related to adverse events after antibiotic treatment in adults with a common infection: impact of COVID-19 and derivation and validation of risk prediction models

BackgroundWith the global challenge of antimicrobial resistance intensified during the COVID-19 pandemic, evaluating adverse events (AEs) post-antibiotic treatment for common infections is crucial. This study aims to examines the changes in incidence rates of AEs during the COVID-19 pandemic and predict AE risk following antibiotic prescriptions for common infections, considering their previous antibiotic exposure and other long-term clinical conditions.MethodsWith the approval of NHS England, we used OpenSAFELY platform and analysed electronic health records from patients aged 18–110, prescribed antibiotics for urinary tract infection (UTI), lower respiratory tract infections (LRTI), upper respiratory tract infections (URTI), sinusitis, otitis externa, and otitis media between January 2019 and June 2023. We evaluated the temporal trends in the incidence rate of AEs for each infection, analysing monthly changes over time. The survival probability of emergency AE hospitalisation was estimated in each COVID-19 period (period 1: 1 January 2019 to 25 March 2020, period 2: 26 March 2020 to 8 March 2021, period 3: 9 March 2021 to 30 June 2023) using the Kaplan–Meier approach. Prognostic models, using Cox proportional hazards regression, were developed and validated to predict AE risk within 30 days post-prescription using the records in Period 1.ResultsOut of 9.4 million patients who received antibiotics, 0.6% of UTI, 0.3% of URTI, and 0.5% of LRTI patients experienced AEs. UTI and LRTI patients demonstrated a higher risk of AEs, with a noted increase in AE incidence during the COVID-19 pandemic. Higher comorbidity and recent antibiotic use emerged as significant AE predictors. The developed models exhibited good calibration and discrimination, especially for UTIs and LRTIs, with a C-statistic above 0.70.ConclusionsThe study reveals a variable incidence of AEs post-antibiotic treatment for common infections, with UTI and LRTI patients facing higher risks. AE risks varied between infections and COVID-19 periods. These findings underscore the necessity for cautious antibiotic prescribing and call for further exploration into the intricate dynamics between antibiotic use, AEs, and the pandemic.

Urinary tract infections in patients with urinary catheterization receiving home health service: A prevalence study

AbstractThis study aimed to determine the prevalence of urinary tract infections in patients with urinary catheterization receiving home health services and the affecting factors. The population of this descriptive study consisted of patients who had lived in the central districts of Erzurum between February and March 2022, were actively registered to home health services, had a urinary catheter and met the research criteria. The period prevalence method (3 months) was used in the study, and 121 patients constituted the study sample. The study data were collected using a Sociodemographic and Information Form on Urinary Catheter. Before the home visit, patients' relatives were asked to clamp the urinary catheter. After completing the data collection forms, a sufficient amount of urine was taken from the attached urinary catheter, put into the urine and culture cup/tube, and labelled with a barcode. The samples were sent to the laboratory within 15 min at the latest. The medical specialist evaluated the results, and the necessary pharmacological treatment was delivered to the patient. Of the patients with indwelling urinary catheters who received home health services, 94.2% had a urinary tract infection. Moreover, it was determined that there was a statistically significant correlation between the presence of urinary tract infection in patients and the variables of constipation, frequency of perineal cleaning, and the use of toilet paper. It was concluded that the prevalence of urinary tract infections is very high in patients with urinary catheterization receiving home health services.

ASSESSMENT OF THE ROLE OF PROPHYLACTIC ANTIBIOTICS IN PREVENTING URINARY TRACT INFECTIONS FOLLOWING UROLOGICAL PROCEDURES: A RANDOMIZED CONTROLLED TRIAL

Urinary tract infection (UTI) can be considered one of the most frequent bacterial infections, and among the main indications for antibiotic use, in children. UTIs affect as much as 2% of the population admitted to community hospitals. Objective: The main objective of this randomized control trial was the assessment of the role of prophylactic antibiotics in preventing urinary tract infections following urological procedures. Methods: This randomized control trial was conducted at Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from February 2023 to February 2024. Data were collected from 185 patients. Data were collected at baseline, immediately post-procedure, and during follow-up visits at 7, 14, and 30 days postoperatively. Baseline data included demographic information, medical history, and details of the urological procedure. Results: Data were collected from 185 patients according to inclusion and exclusion criteria. The average ages were 55.2 ± 12.3 and 54.8 ± 11.9 years, respectively. Both groups had a comparable gender distribution with approximately 70% male and 30% female. BMI was also similar, with averages of 26.7 ± 4.5 for the intervention group and 26.9 ± 4.3 for the control group. The intervention group (n=93) had 7 patients (7.5%) who experienced antibiotic-related adverse events, while the control group (n=92) reported no adverse events (0%).Conclusion: It is concluded that prophylactic antibiotics significantly reduce the incidence of postoperative urinary tract infections in patients undergoing urological procedures.

Analisis Penggunaan Antibiotik Pada Pasien Infeksi Saluran Kemih (ISK) Secara Kuantitatif Di RSUD Provinsi NTB Tahun 2019

Introduction: Urinary Tract Infection (UTI) is a disease that often occurs in developing countries after upper respiratory tract infections. The incidence of UTI in 2018 in Indonesia is quite high, ranging from 39-60%. Antibiotics are the main therapy for UTIs, but excessive and inappropriate use of antibiotics can cause occurrence of antibiotic resistance. Objective: This study aims to quantitatively analyze patterns of antibiotic use in UTI patients at the NTB Provincial Hospital in 2019. Methods: This type of research is descriptive in nature using a cross-sectional design. There were 47 patients in case who were diagnosed with UTI ith the ICD-X code N39.0, which means the UTI suffered by the patient was a non-specidic type of UTI. Quantitative use of antibiotics was calculated using the ATC/DDD method according to WHO standards. Results: The total value of DDD/100 Patient-days was 51.26 with ceftriaxone as an antibiotic with the highest DDD/100 patient-days value of 19.78 and had the largest value in the 90% DU segment, which was 38.59%. Conclusion: Regular evaluation of antibiotic use is needed to minimize excessive use of antibiotics so that rational antibiotic use can be achieved.

Detection of virulence iroN gene in Klebsiella pneumoniae in urinary tract infections patients from Iraq

Klebsiella pneumoniae belongs to the family Enterobacteriaceae, and it is the most clinically pertinent species, also it causes both nosocomial and communities-acquired infections, such as liver abscesses, urinary infections, pneumonia, and bacteremia. The current study aimed to detect the virulence iroN gene in Klebsiella pneumoniae for patients with urinary tract infections. One hundred fifty collected 75 samples of urine and 75 samples of blood samples from patients with urinary tract infections from Ibn Al-Baladi Hospital/ Baghdad -Iraq from November 2023 to February 2024. The results showed the diagnosis of 60 isolates of bacteria with an 80% prevalence of Klebsiella pneumoniae observed percentage for the age (more than 60 years) was 80% higher than for age (less than 60 years) was 20%. Moreover, females recorded 55% and males 45%. Also, blood group O has a percentage (33.3% ) more than other groups A (23.3%), AB(30%), and B (13.3%). The results of antibiotic resistance of Klebsiella pneumoniae showed 100% resistance toward Cefoxitin Screen, Amoxicillin/ Clavulanic acid, Ticarcillin/ Clavulanic Acid, Piperacillin, Piperacillin/Tazobactam, Cefmetazole, Ceftazidim, Cefepime, Aztreonam, Amikacin, Ciprofloxacin). In contrast, it was 63.3 % for (Meropenem, Gentamicin, Tobramycin),66.7%for Trimethoprim / Sulfamethoxazole, and 61.6% for Imipenem. Moreover, these isolates were sensitive to Ticarcillin (100%), Minocycline (83%). Besides, the results of the virulence gene showed iroN gene was found in 38(63.3%) isolates out of 60 isolates. In conclusion, this study appeared to the prevalence resistance of K. pneumoniae in urinary infections with the presence of iroN gene.

In-vitro Antibacterial Activity of Crude Extracts of Annona senegalensis Against Selected Bacteria Associated with Urinary Tract Infections

The study assessed the antibacterial activity of aqueous, ethyl acetate and methanol extracts of leaves, bark, and roots of A. senegalensis against selected bacteria associated with urinary tract infections (UTIs). The extracts of A. senegalensis were obtained by soxhlet extraction method. Qualitative phytochemical screening of the extracts was carried out using standard procedures. The bacteria tested were Klebsiella pneumoniae and Pseudomonas aeruginosa isolated from urine samples of UTI patients. Antimicrobial susceptibility testing was carried out using the agar well diffusion method, while minimum inhibitory concentration (MIC) was determined by broth dilution method using two-fold serial dilutions. The qualitative phytochemical analysis showed the presence of phenols, tannins, terpenoids, flavonoids, steroids, saponins, and cardiac glycosides. Zones of inhibition of extracts ranged between 16.33±0.58 – 24.67±0.58 mm (leaf extracts), 14.00±1.00 – 21.33 ±0.58 mm (bark extracts) and 14.67±0.58 – 21.00±1.00 mm (root extracts). The higest zone of inhibition (24.67±0.58 mm) observed was against Pseudomonas aeruginosa with aqueous leaf extract, while the least inhibition (14.00±1.00 mm) was with ethyl acetate bark extract, also against Pseudomonas aeruginosa. MIC values ranged from 25 – 100 mg/mL, while MBC values were from 50 – 200 mg/mL against the test isolates. A. senegalensis demonstrated great antibacterial potential, and can be recommended for the treatment of UTIs.

Melissa officinalis Extract as an Antimicrobial Agent Against Clinical Bacterial Strains Isolated from Urinary Tract Infections in Najaf, Iraq

Background: Antibiotics are used to inhibit the growth of bacterial infections. However, antibiotic resistance is increasing due to their use. Plant extracts are natural compounds with unique medical properties. The current study investigated the effect of Melissa officinalis collected from Marivan, Iran, against urinary tract infection (UTI). Methods: The plant extract was prepared using the Soxhlet method. The bacterial strains were isolated from UTI patients at AlZahra Hospital in Najaf, Iraq. The antibacterial activity of M. officinalis extract was evaluated using the Kirby-Bauer disk diffusion method. The minimal inhibitory concentration (MIC) was also determined by the microdilution method. Results: According to the inhibition zone results, M. officinalis greatly affected Staphylococcus aureus, Proteus vulgaris, and Klebsiella pneumoniae. The plant extract showed the highest antimicrobial activity on the standard and clinical strains of S. aureus with the highest inhibition zone record of 8.4±0.163 and 9±0.0 mm and MIC of 0.09 and 0.06 mg/mL, respectively. Also, M. officinalis extract indicated an antimicrobial effect against the standard and clinical strains of K. pneumoniae with the highest inhibition zone record of 8±0.0 and 9±0.0 mm and MIC of 0.06 and 0.06 mg/mL, respectively. Furthermore, the plant extract showed the most antimicrobial activity on the standard and clinical strains of P. vulgaris, with the highest records of 7.9±0.23 and 9±0.0 mm and MICs of 0.14 and 0.06 mg/mL, respectively. Conclusion: Melissa officinalis extract can be a suitable candidate as an alternative to antibiotics for treating UTIs.

Descriptive Study of the Urinary Tract Infections in Patients Admitted in the Cardiology Ward of Afghan Momand Medical Complex

Urinary Tract Infection (UTI) is very common in our community most specifically in married females with numerous antecedent risk factors. The aim of the study was to find out about the current risk factors and clinical profile of urinary tract infections in patients admitted to the cardiology ward of Afghan Momand Medical Complex for various purposes. It was a cross-sectional descriptive hospital-based study including both male and female patients visiting the Afghan Momand Medical Complex from January 2022 to June 2022. Of all 960 patients, 202 (21%) patients had urinary tract infections with gender distribution as 69 (34.2%) males and 133 (65.8%) females. In fact, 33 (16.3%) patients with urinary tract infections were single while the rest 169 (83.7%) patients were married. In addition, regarding clinical profile, the following clinic was respectively more prevalent: Dysuria in 120 (59.4%) patients, flank pain in 73 (36.1%) patients, urine frequency in 67 (33.1%) patients, urgency in 36 (17.8%) patients, fever in 24 (11.8%) patients, and nausea and vomiting in 19 (9.4%) patients. Moreover, the following risk factors were respectively the most common ones: Diabetes mellitus 86 (42.5%), pregnancy 30 (14.9%), stones 15 (7.4%), 10 (4.9%) devices, 10 (4.9%) prostatic hyperplasia, and 4 (2%) anatomical anomalies. Urinary tract infection is a common disease in the admitted patients in Afghan Momand Medical Complex specifically being more common in females and early 20s of the age. In fact, diabetes, pregnancy, and kidney stones were the leading associated factors with UTI. Moreover, dysuria, bladder emptying irritative symptoms, and abdominal pain were the most prevalent clinical profile of the patients. Special attention should be paid to infectious diseases in cardiac patients since infection itself is a stress and a threat to such patients and authorities should design special measures to prevent UTI in the general population to avoid a sum of burden on the health system.

Frequency and Resistance Pattern of Carbapenemases (Class A & B) in E. Coli and Klebsiella Species

Abstract: Background: Carbapenems are potent and strong antibiotics that are usually reserved as last resort for bacteria possessing basic antibiotic resistance. These are broad spectrum drugs with more effective coverage against gram negative organisms. The antibiotic resistance pattern observed in bacteria possessing chromosomal group 2f β-lactamases is unique. It involves resistance to carbapenems while remaining sensitive to broadly attacking cephalosporins. Objective: This study aims to provide assessment of frequency of class A & B carbapenamase in E.coli and Klebsiella species producers and establish the resistance pattern from clinical isolates, at a tertiary care hospital in Karachi. Materials and Methods: This is a cross sectional, prospective study conducted at general hospital liyari, Karachi during Jan 2022- Jan 2023. Sample size was calculated as 400. Samples were divided into Urine samples of urinary tract infection patients (n=150), Pus sample from different sites (n=100), Respiratory tract, tracheal aspirates and sputum sample (n=100) and blood sample from suspected septicemia (n=50). SPSS-22 was used to enter and analyze the data. Chi-square test was used to analyze significance between two mean values, keeping ≤0.05 as significant p-value. Result: Distribution of microorganisms were reported as 120 (41.1%), 80 (28.5%), 2 (0.69%), 24 (8.36%), 55 (19.1%) and 6 (2%) of E. coli, Klebsiella Pneumonia, K.Oxytoca, Gram positive. Gram negative and Yeast respectively. The confirmed presence of carbapenemase (CP) was identifies in urine sample as 4/6 (26.6%) E.coli and 2/6 (13.3%) Klebsiella, while pus samples identifies 3/4 (20%) E.coli and 1/4 (6.6%) Klebsiella. Similarly samples of respiratory tract identifies 2/5 (13%) of E.coli and 3/5 (20%) of Klebsiella. The calculated p-value was insignificant with 0.834 and 0.913 for E.coli and Klebsiella respectively. Conclusion: This study concludes that E.coli is by far the most frequently reported microorganism from class B while class A organisms are in lower frequencies. CRE indicated higher resistance from non-β-lactam antibiotics, limiting treatment options. Keywords: Phenotypic, Detection, Resistance, Carbapenemases, E. coli, Klebsiella.

Incidence of urinary tract infections in patients with permanent percutaneous nephrostomy after implementation of a standardized care program.

Percutaneous nephrostomy tubes (PNT), which are used in some cancer hospitals, are associated with an increase in urinary tract infections (UTI). To determine the impact of a standardized care program on the incidence of UTIs requiring hospitalization (UTI-RH). Retrospective study that included patients with a first PNT inserted. The incidence, relative risk (RR), costs and outcomes of patients with UTI-RH were compared during the period before (P0) vs. after the intervention (P1). 113 PNTs were inserted during P0, and 74 at P1. During P0, 61 patients (53.9%) experienced 64 UTI-RH events in 22,557 PNT days. At P1, four patients (5.4%) had a UTI-RH in 6,548 PNT days (IRR: 0.21, 95% CI: 0.05-0.57). The RR was 0.09 (95% CI: 0.03-0.25). Monthly cost per day/bed was USD 3,823 at P0 and USD 1,076 at P1, and for antibiotics, it was USD 790 at P0 and USD 123.5 at P1. This study highlights the importance of a standardized care program for permanent percutaneous devices, since this reduces antibiotic use, hospitalization, and the cost of care.

Anti-Microbial Effects of Vaccinium Macrocarpon (Cranberry) Extract on Serotypes 26 and 45 of Escherichia Coli as a Prophylaxis of Recurrent Urinary Tract Infection (UTI)

Background: Urinary tract infection (UTI) is the second most common type of bacterial infection globally, affecting people of different age groups. Cranberry is renowned for its antibacterial properties and has been used to treat UTIs in recent years. Objective: This study aimed to assess the antimicrobial effects of cranberry extract on the prophylaxis of recurrent UTI caused by different serotypes of Escherichia coli (E. coli). Methods: This quasi-experimental study recruited 60 recurrent UTI patients from the Urology department of King Edward Medical University, Lahore, Pakistan. Patients with a history of recurrent UTIs caused by E. coli were included. Urine microscopy and culture tests were performed, and only E. coli-positive cases were serotyped. Patients received Vaccinium macrocarpon (cranberry) extract at a dose of 500 mg/day for four weeks along with their standard treatment. Follow-up evaluations were conducted after one and three months to assess UTI symptoms and the presence of E. coli in urine samples. Statistical analysis was performed using SPSS version 25, with quantitative variables expressed as mean ± standard deviation and qualitative variables as frequencies and percentages. Results: Of the 60 patients, 15 (25%) were positive for E. coli. Serotyping revealed 8 patients (53%) with serotype 26 and 7 patients (47%) with serotype 45. After three months of treatment, cranberry extract eradicated E. coli in 12 patients (80%); specifically, it eradicated 100% of serotype 45 and 62% of serotype 26 cases. Conclusion: Cranberry extract (500 mg/day) for three months demonstrated significant antimicrobial effects on E. coli serotypes 26 and 45, with greater efficacy observed in serotype 45. These findings suggest cranberry extract as a potential prophylactic treatment for recurrent UTIs. Keywords: Cranberry extract, recurrent UTI, E. coli serotypes, antimicrobial effects, prophylactic treatment, Vaccinium macrocarpon, urinary tract infection, Escherichia coli

Evaluation of the Quantity and Quality of Antibiotic Use in Inpatient Pediatric Urinary Tract Infection (UTI) Patients at RSUD KRMT Wongsonegoro Semarang

Evaluation of the Quantity and Quality of Antibiotic Use in Inpatient Pediatric Urinary Tract Infection (UTI) Patients at RSUD KRMT Wongsonegoro Semarang

Neutrophil-lymphocyte ratio as a biomarker for urinary tract infection in female patients at Thumbay University Hospital, Ajman

Short urethras make urinary tract infections (UTIs) common in women. Therefore, bacteria can enter the bladder more easily. This research aimed to determine if the neutrophil-to-lymphocyte ratio (NLR) can be used as a biomarker in UTI patients and compare C-reactive protein (CRP) and NLR to identify which is more effective in diagnosing UTI patients. This study examined urine culture, NLR, and CRP values in blood from 101 Thumbay University Hospital patients with UTI. Control group NLR and CRP values of 100 participants were also examined. NLR mean for UTI patients was 6.9881. The NLR mean for UTI-free participants was 3.0839. Comparison of NLR values between UTI patients and non-UTI patients showed significant results (P=<0.001). Thus, patients with UTI had significantly higher NLR results than those without UTI, indicating a strong correlation between UTI and higher NLR values. Our results showed that UTI patients had higher NLR and CRP values than healthy controls. In patients with UTI, clinical assessment of symptoms and complaints should be done first, followed by NLR and CRP as inflammatory markers.

Genetic Characterization and Phylogenetic Analysis of Escherichia Coli Isolates from Urinary Tract Infections in Iraq

This study aimed to characterize Escherichia coli (E. coli) isolates from urinary tract infections (UTIs) in Iraq and compare them with international strains. Twenty midstream urine samples from UTI patients were cultured on MacConkey and nutrient agar plates. All bacterial isolates were identified using Vitek 2 system, followed by DNA extraction with the Goya Gene kit. Specific primers were used to detect E. coli, and positive samples were sequenced using the Sanger method. Phylogenetic analysis was conducted to elucidate the genetic relationships among the isolates. The results revealed a high similarity between local Iraqi E. coli isolates and national strains, with minor differences. The phylogenetic tree analysis identified three distinct strains, with an 81% similarity among most isolates, though one international strain was notably distant. The study highlights on rising the frequency of UTIs and the monetary problems they impose on both the governments and patients, emphasizing the need for active drugs that can be rapidly implemented in medical settings. This research underscores the importance of understanding local bacterial populations to inform treatment strategies, as UTIs commonly result from bacterial resistance to existing treatments. UPEC frequently targets the urethra, bladder, and kidneys, initiating infections through colonization and subsequent invasion of the bladder epithelium.

Microbial communities, antibiotic resistance genes, and virulence factors in urinary infectious stone-associated urinary tract infections.

Urinary infectious stones are challenging due to bacterial involvement, necessitating a comprehensive understanding of these conditions. Antibiotic-resistant urease-producing bacteria further complicate clinical management. In this study, analysis of urine and stone samples from urinary tract infection (UTI) patients revealed microbial shifts, gene enrichment in stones, and metabolic pathway disparities; antibiotic resistance gene trends were phylum-specific, urease-producing bacteria are at risk of acquiring AMR carried by Enterobacteriaceae under antibiotic, emphasizing potential AMR dissemination between them; Correlations of key pathogenic species in kidney stone and urine microbial communities highlight the need for targeted therapeutic strategies to manage complexities in UTIs; Stones and urine contain a variety of deleterious genes even before antibiotic use, and piperacillin/tazobactam better reduced the abundance of antibiotic resistance genes in stones and urine. The presence of diverse antibiotic resistance and virulence genes underscores challenges in clinical management and emphasizes the need for effective treatment strategies to mitigate risks associated with UTIs and urinary infectious stone formation. Ongoing research is vital for advancing knowledge and developing innovative approaches to address these urological conditions.

Colistin-resistance genes in Escherichia coli isolated from patients with urinary tract infections.

The incidence of antimicrobial resistance is alarmingly high because it occurs in humans, environment, and animal sectors from a "One Health" viewpoint. The emergence of plasmid-carried mobile colistin-resistance (MCR) genes limits the efficacy of colistin, which is the last-line treatment for multidrug resistance (MDR) against gram-negative infections. The current study aimed to investigate emergence of colistin-resistance (MCR 1-5) genes in E. coli isolated from patients with urinary tract infections (UTIs) in Jordan. E. coli (n = 132) were collected from urine specimens. The E. coli isolated from human UTI patients were examined the resistance to colistin based on the presence of MCR (1-5). All isolates were tested against 20 antimicrobials using the standard disk diffusion method. The broth microdilution technique was used to analyze colistin resistance. In addition, the MCR (1-5) genes were detected using multiplex PCR. Out of the 132 isolates, 1 isolate was colistin-resistant, having a minimum inhibitory concentration of 8 μg/mL and possessing MCR-1. All the E. coli isolates showed high resistance to penicillin (100%), amoxicillin (79.55%), cephalexin (75.76%), nalidixic acid (62.88%), tetracycline (58.33%), or cefepime (53.79). To our knowledge, this is the first report on the presence of plasmid-coded MCR-1 in E. coli from a patient with UTIs in Jordan. This is a problematic finding because colistin is the last-line drug for the treatment of infections caused by MDR gram-negative bacteria. There is a crucial need to robustly utilize antibiotics to control and prevent the emergence and prevalence of colistin-resistance genes.

Detection fimH Gene in The Urine of UTI Patients at The Puskesmas Banyuanyar, as a Marker for The Presence of Escherichia coli

Urinary Tract Infection (UTI) is a bacterial infection characterized by a urine culture showing bacteriuria with bacterial counts exceeding 100,000 per milliliter of urine. Polymerase Chain Reaction (PCR) is a method that utilizes in-vitro enzymatic reactions to amplify specific DNA targets. This process synthesizes new DNA strands complementary to the target sequences using enzymes and oligonucleotide primers within a thermocycler. The fimH gene is among the most important of the UPEC strains and is associated with severe urinary tract infections. The aim of this study was to identify the presence of the fimH gene in urine samples from UTI patients at the Puskesmas Banyuanyar in Surakarta using Polymerase Chain Reaction (PCR). The research employed the Quota Sampling Technique, collecting a total of five urine samples from individuals diagnosed with urinary tract infections. The results of the control isolates using pure Escherichia coli isolates showed that the fimH gene PCR amplified control with annealing temperature of 52°C. The analysis of clinical isolates of Escherichia coli from the urine of urinary tract infection patients revealed that the fimH gene was PCR amplified in all five samples.

Investigation of Interleukine-1 Beta in Urinary Tract Infection Patients

Objective: The study aims to investigate interleukin -1 beta (IL-1 ) in patients with urinary tract infections in the holy governorate of Karbala. Methods: This study was conducted during the period from October 2023 to February 2024 at Imam Hussein Hospital in the holy city of Karbala and the laboratories of the College of Applied Medical Sciences/University of Kerbala. The current study included collecting urine samples (for use in general urine examination) and blood (using blood directly to measure the complete blood count CBC and serum to measure interleukin -1 beta (IL-1 ) from 70 patients with urinary tract infection (35 patients with positive bacterial growth and 35 patients with negative bacterial growth) in addition to 70 healthy people. The following general criteria were also investigated: age, sex, height, and weight. Results: Eight bacterial species were obtained. From the findings of the study is the increase in concentration of IL-1 in patients with urinary tract infections compared to the control group. The presence of a negative correlation between LBP and IL-1 . Conclusions: Increase the concentration of IL-1 in patients with urinary tract infections. There is a negative correlation in patients with bacterial growth between LBP and IL-1 .