Urinary Tract Infection Pathogens Research Articles

First Detection of Klebsiella pneumoniae Isolate Co-Harboring Fosfomycin Resistance Gene fosA3 and blactx-m Among Gram Negative Urine Isolates in a Turkish Hospital.

The most common gram-negative pathogens in urinary tract infections are Escherichia coli and Klebsiella pneumoniae. Therapy that is often empirical relies on local antibiotic resistance data, hence monitorization of antimicrobial resistance periodically in each hospital is a requirement. In this study, antibiotic susceptibility profiles of consecutive urinary isolates (E. coli [n = 235] and K. pneumoniae [n = 56]) of adult patients collected between February 2018 and February 2019 from inpatients in Hacettepe University Hospital were assessed. Isolates resistant to fosfomycin (minimum inhibitory concentration >32 mg/L) were further investigated for the presence of fosA, fosA3, and fosC2. Fosfomycin susceptibility was determined by agar dilution method. Broth microdilution method was performed for amikacin, gentamicin, ceftazidime, ceftriaxone, meropenem, ciprofloxacin, tigecycline, trimethoprim/sulfamethoxazole (TMP/SMX), colistin, and piperacillin/tazobactam (PIP/TAZ). PCR method was employed to investigate fosA, fosA3, fosC2, and blaCTX-M. Existence of fosA3 gene was confirmed by sequencing. Resistance rates to amikacin, gentamicin, ceftazidime, ceftriaxone, meropenem, ciprofloxacin, tigecycline, TMP/SMX, colistin, and PIP/TAZ were 2.7%, 18.5%, 25.4%, 33.0%, 3.4%, 45.4%, 2.4%, 43.6%, 6.2%, and 23.7%, respectively. Sixteen isolates (5.5%) were resistant to fosfomycin. Resistance was most frequently observed in K. pneumoniae (n = 9). fosA3 gene was detected in one fosfomycin-resistant K. pneumoniae isolate. This isolate also carried blaCTX-M. fosC2 and fosA genes could not be detected in any of the isolates. In this study, we report for the first time the existence of fosA3 in Turkey and its association with the blaCTX-M gene. As a result of increasing blaCTX-M producing Enterobacterales isolates globally, increase in fosfomycin resistance may be expected in near future.

Spectrum of antibiotic resistance in UTI caused by Escherichia coli among HIV-infected patients in Uganda: a cross-sectional study

BackgroundAntimicrobial drug resistance is one of the top ten threats to global health according to the World Health Organization. Urinary tract infections (UTIs) are among the most common bacterial infections and main reason for antibiotic prescription. The incidence of UTIs appears to be high among people living with HIV. We sought to determine the most common UTI pathogens among HIV infected patients and evaluate their susceptibility towards antibiotics.MethodsWe performed a cross-sectional study among HIV-infected patients aged ≥ 18 years presenting at an HIV care specialized clinic with symptoms suggestive of a urethritis. Urine cultures were subjected to antibiotic susceptibility testing according to Clinical Laboratory Standards Institute. The data was analyzed using STATA, we performed Pearson’s Chi-square and Fisher’s exact tests to compare differences between proportions.ResultsOut of the 200 patients, 123 (62%) were female. The median age was 41.9 years (IQR 34.7–49.3). Only 32 (16%) urine cultures showed bacterial growth. Escherichia coli was the most commonly isolated uropathogen (72%), followed by Klebsiella pneumoniae (9%). E. coli was completely resistant to cotrimoxazole and ampicillin; resistance to ciprofloxacin and ceftriaxone was 44% and 35% respectively; 9% to gentamicin; no resistance detected to nitrofurantoin and imipenem.ConclusionsOur findings are congruent with the Uganda national clinical guidelines which recommends nitrofurantoin as the first line antibiotic for uncomplicated UTI. Significant ciprofloxacin and ceftriaxone resistance was detected. In the era of emerging antibiotic resistance, understanding the local susceptibilities among sub-populations such as HIV infected patients is crucial. Further investigation is needed to address reasons for the low bacterial growth rate observed in the urine cultures.

The Relationship between Antibiotic Susceptibility and pH in the Case of Uropathogenic Bacteria.

Urinary tract infections (UTIs) are common bacterial infections caused mainly by enteric bacteria. Numerous virulence factors assist bacteria in the colonization of the bladder. Bacterial efflux pumps also contribute to bacterial communication and to biofilm formation. In this study, the phenotypic and genetic antibiotic resistance of clinical UTI pathogens such as Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis were determined by disk diffusion method and polymerase chain reaction (PCR). Following this, different classes of antibiotics were evaluated for their antibacterial activity at pH 5, 6, 7 and 8 by a microdilution method. Gentamicin (GEN) was the most potent antibacterial agent against E. coli strains. The effect of GEN on the relative expression of marR and sdiA genes was evaluated by quantitative PCR. The slightly acidic pH (pH 6) and GEN treatment induced the upregulation of marR antibiotic resistance and sdiA QS activator genes in both E. coli strains. Consequently, bacteria had become more susceptible to GEN. It can be concluded that antibiotic activity is pH dependent and so the artificial manipulation of urinary pH can contribute to a more effective therapy of multidrug resistant bacterial infections.

In Vitro Killing of Canine Urinary Tract Infection Pathogens by Ampicillin, Cephalexin, Marbofloxacin, Pradofloxacin, and Trimethoprim/Sulfamethoxazole.

Urinary tract infections are common in dogs, necessitating antimicrobial therapy. We determined the speed and extent of in vitro killing of canine urinary tract infection pathogens by five antimicrobial agents (ampicillin, cephalexin, marbofloxacin, pradofloxacin, and trimethoprim/sulfamethoxazole) following the first 3 h of drug exposure. Minimum inhibitory and mutant prevention drug concentrations were determined for each strain. In vitro killing was determined by exposing bacteria to clinically relevant drug concentrations and recording the log10 reduction and percent kill in viable cells at timed intervals. Marbofloxacin and pradofloxacin killed more bacterial cells, and faster than other agents, depending on the time of sampling and drug concentration. Significant differences were seen between drugs for killing Escherichia coli, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus pseudintermedius strains. At the maximum urine drug concentrations, significantly more E. coli cells were killed by marbofloxacin than by ampicillin (p < 0.0001), cephalexin (p < 0.0001), and TMP/SMX (p < 0.0001) and by pradofloxacin than by cephalexin (p < 0.0001) and TMP/SMX (p < 0.0001), following 5 min of drug exposure. Rapid killing of bacteria should inform thinking on drug selection for short course therapy for uncomplicated UTIs, without compromising patient care, and is consistent with appropriate antimicrobial use and stewardship principles.

Медико-соціальна складова медичного менеджменту: удосконалення моделі надання медичної допомоги дітям з інфекційно-запальними захворюваннями сечовидільної системи

The purpose of the study was to substantiate and develop the improved model of the specialized nephrology care for the children with infectious inflammatory diseases of the urinary system at the regional level. Materials and methods. The official statistical data have been studied (reports on the state of medical care for children in the Chernivtsi region and data from the Center of medical statistics of the Ministry of Healthcare from 2006 to 2017), information-analytical and statistical methods have been used. The modern etiological structure of uropathogens – urinary tract infection pathogens among the children of the Chernivtsi region (2009-2016) was studied. Clinical and laboratory examination of 3,089 children (0-17 years old) was conducted in the region; the regional spectrum of sensitivity to antibacterial drugs was determined among the main groups of urinary tract infection pathogens; their age, gender and administrative-territorial differences among the children's population of the region are analyzed. Results and discussion. During 2012-2017 there was a significant increase (by 23.0%) in the incidence of infectious and inflammatory groups of the urinary system diseases among children of 0-14 years old, while among adolescents there was simultaneously an intensive decrease in indicators (by 40.0%) compared to 8.7% in 2006-2011. The ratio of indicators and their dynamics suggests that the growth of sick adolescents is largely due to the insufficient effectiveness of medical care, while children of 0-14 years old is due to their low and insufficient prevention. The data formed the foundation for substantiation and development of an improved functional-organizational model of the system. In addition to the existing and functionally changed elements the model contains new elements: regional/inter-regional center of specialized medical aid for children with infectious-inflammatory diseases of the urinary system. Conclusion. Implementation of the elements of the suggested improved model in a part of a rational approach in distribution of functions concerning medical observation of patients at the stages of providing medical aid enabled to make the period of hospitalization of nephrological patients by 11.40% shorter and an average period of treatment of patients with infectious-inflammatory diseases of the urinary system by 2.93% shorter. Efficiency of implementation of certain elements of the suggested model with its positive evaluation by independent experts and its compliance with the strategy of branch reforms enables to recommend the improved functional-organization model of providing medical aid for children with infectious-inflammatory diseases of the urinary system at the regional level to be introduced into the health care system of Ukraine

Oxalate Alters Cellular Bioenergetics, Redox Homeostasis, Antibacterial Response, and Immune Response in Macrophages.

Individuals with calcium oxalate (CaOx) kidney stones can have secondarily infected calculi which may play a role in the development of recurrent urinary tract infection (UTI). Uropathogenic Escherichia coli (UPEC) is the most common causative pathogen of UTIs. Macrophages play a critical role in host immune defense against bacterial infections. Our previous study demonstrated that oxalate, an important component of the most common type of kidney stone, impairs monocyte cellular bioenergetics and redox homeostasis. The objective of this study was to investigate whether oxalate compromises macrophage metabolism, redox status, anti-bacterial response, and immune response. Monocytes (THP-1, a human monocytic cell line) were exposed to sodium oxalate (soluble oxalate; 50 µM) for 48 hours prior to being differentiated into macrophages. Macrophages were subsequently exposed to calcium oxalate crystals (50 µM) for 48 hours followed by UPEC (MOI 1:2 or 1:5) for 2 hours. Peritoneal macrophages and bone marrow-derived macrophages (BMDM) from C57BL/6 mice were also exposed to oxalate. THP-1 macrophages treated with oxalate had decreased cellular bioenergetics, mitochondrial complex I and IV activity, and ATP levels compared to control cells. In addition, these cells had a significant increase in mitochondrial and total reactive oxygen species levels, mitochondrial gene expression, and pro-inflammatory cytokine (i.e. Interleukin-1β, IL-1β and Interleukin-6, IL-6) mRNA levels and secretion. In contrast, oxalate significantly decreased the mRNA levels and secretion of the anti-inflammatory cytokine, Interleukin-10 (IL-10). Further, oxalate increased the bacterial burden of primary macrophages. Our findings demonstrate that oxalate compromises macrophage metabolism, redox homeostasis, and cytokine signaling leading to a reduction in anti-bacterial response and increased infection. These data highlight a novel role of oxalate on macrophage function.

Enterococcus hirae bacteremia associated with acute pyelonephritis in a patient with alcoholic cirrhosis: a case report and literature review

BackgroundInfections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare. Further, few cases have been reported in humans because of the difficulty in identifying the bacteria. Herein, we report a case of pyelonephritis caused by E. hirae bacteremia and conduct a literature review on E. hirae bacteremia.Case presentationA 57-year-old male patient with alcoholic cirrhosis and neurogenic bladder presented with fever and chills that had persisted for 3 days. Physical examination revealed tenderness of the right costovertebral angle. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) of the patient’s blood and urine samples revealed the presence of E. hirae, and pyelonephritis was diagnosed. The patient was treated successfully with intravenous ampicillin followed by oral linezolid for a total of three weeks.ConclusionThe literature review we conducted revealed that E. hirae bacteremia is frequently reported in urinary tract infections, biliary tract infections, and infective endocarditis and is more likely to occur in patients with diabetes, liver cirrhosis, and chronic kidney disease. However, mortality is not common because of the high antimicrobial susceptibility of E. hirae. With the advancements in MALDI-TOF MS, the number of reports of E. hirae infections has also increased, and clinicians need to consider E. hirae as a possible causative pathogen of urinary tract infections in patients with known risk factors.

Combination of bactericidal antibiotics and inhibitors of Universal stress protein A (UspA): a potential therapeutic alternative against multidrug resistant Escherichia coli in urinary tract infections.

The increasing incidence of multidrug resistant uropathogenic E. coli (MDR-UPEC), the most common opportunistic pathogen in urinary tract infections (UTI) pose a global health problem and demands searching for alternative therapeutics. Antibiotics generate oxidative stress in bacteria which results in overexpression of the universal stress protein, UspA that helps in bacterial survival. An in silico study showed that two compounds ZINC000104153710, and ZINC000000217308 effectively bound bacterial UspA. This study aimed to determine the activity of ZINC000104153710, and ZINC000000217308 against bacterial UspA function in MDR-UPEC in vitro. Twenty-five highly MDR-UPEC were screened against ZINC000104153710, and, ZINC000000217308 either alone or in combination with the bactericidal antibiotics; ciprofloxacin (CIP), ceftazidime(CAZ), gentamicin(GEN) respectively by determining minimum inhibitory concentrations (MICs) using a broth microdilution assay. Additionally, the effect of ZINC000104153710, and ZINC000000217308 in the absence and presence of antibiotics on the bacteria was monitored by bacterial growth curve assays, ROS production, structure of the organism by scanning electron microscopy (FESEM) and quantitating UspA using a western blot technique. A 2-8 fold reduction in MIC values against ZINC000104153710, and ZINC000000217308 was observed against all 25 MDR-UPEC isolates in the presence of antibiotics with no alteration in intracellular ROS production. Discrete changes in cell morphology was evident in bacteria treated with ZINC000104153710 or ZINC000000217308 and antibiotics individually by FESEM compared with untreated control. Reduction in the level of UspA protein in bacteria treated with combination of ZINC000104153710 or ZINC000000217308 with individual antibiotics established their ability to inhibit UspA whose expression was elevated in presence of antibiotics alone. Therefore this study validated ZINC000104153710, and ZINC000000217308 as potent inhibitors of bacterial UspA function and indicated their potential as alternative therapeutics to combat the MDR-UPEC.

Резистентність до протимікробних препаратів серед клінічних ізолятів, виділених при інфекції сечових шляхів у дітей

Актуальність. Інфекція сечових шляхів (ІСШ) — одна з основних причин госпіталізації дітей до стаціонару. Однією з основних причин неефективного лікування ІСШ у дітей є антибіотикорезистентність збудників ІСШ. Метою дослідження було визначення стану поширеності антибіотикорезистентності серед збудників інфекції сечових шляхів. Матеріали та методи. Дослідження антибіотикорезистентності проводилося на 61 клінічному ізоляті, що були виділені зі зразків сечі дітей, які були госпіталізовані з приводу захворювання на різні форми ІСШ. Визначення чутливості до 23 антимікробних препаратів здійснювалося за допомогою методу антимікробних дисків з подальшим визначенням зон затримок росту. Результати. Найбільшу ефективність щодо збудників інфекцій сечових шляхів мали представники групи аміноглікозидів (амікацин — до 91,9 % клінічних ізолятів, гентаміцин — до 82 %). Цефалоспорини ІІІ покоління мали різний рівень антибіотикорезистентності, що коливалася у межах від 11,8 % (цефтизоксим) до 42,5 % (цефподоксим). Зберігається високий рівень чутливості до синтетичних протимікробних препаратів: чутливість до фурагіну становила 89,8 %, до фосфоміцину — 86,5 %. Висновки. Рівень антибіотикорезистентності щодо збудників ІСШ значно варіює у різних антибактеріальних препаратів, а також залежно від форми ІСШ, тому проведення дослідження антибіотикорезистентності є важливим етапом в лікуванні хворих на ІСШ.

Bioengineered phytomolecules-capped silver nanoparticles using Carissa carandas leaf extract to embed on to urinary catheter to combat UTI pathogens.

Rising incidents of urinary tract infections (UTIs) among catheterized patients is a noteworthy problem in clinic due to their colonization of uropathogens on abiotic surfaces. Herein, we have examined the surface modification of urinary catheter by embedding with eco-friendly synthesized phytomolecules-capped silver nanoparticles (AgNPs) to prevent the invasion and colonization of uropathogens. The preliminary confirmation of AgNPs production in the reaction mixture was witnessed by the colour change and surface resonance plasmon (SRP) band at 410nm by UV-visible spectroscopy. The morphology, size, crystalline nature, and elemental composition of attained AgNPs were further confirmed by the transmission electron microscopy (TEM), selected area electron diffraction (SAED), X-ray diffraction (XRD) technique, Scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The functional groups of AgNPs with stabilization/capped phytochemicals were detected by Fourier-transform infrared spectroscopy (FTIR). Further, antibiofilm activity of synthesized AgNPs against biofilm producers such as Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were determined by viability assays and micrographically. AgNPs coated and coating-free catheters performed to treat with bacterial pathogen to analyze the mat formation and disruption of biofilm formation. Synergistic effect of AgNPs with antibiotic reveals that it can enhance the activity of antibiotics, AgNPs coated catheter revealed that, it has potential antimicrobial activity and antibiofilm activity. In summary, C. carandas leaf extract mediated synthesized AgNPs will open a new avenue and a promising template to embed on urinary catheter to control clinical pathogens.

Profiles and genetic determinants of antimicrobial resistance in pathogens causing community-acquired urinary tract infections in reproductive-age women

Objective. To characterize the profiles and genetic determinants of antibiotic resistance in pathogens of community-acquired urinary tract infections (UTI) in women of reproductive age in St. Petersburg (Russia).Materials and methods. The study included strains of microorganisms obtained from 145 women of reproductive age with diagnosed with a UTI. Antibiotic susceptibility was evaluated by disk diffusion method; the interpretation of the results was carried out in accordance with the EUCAST criteria. Strains of uropathogenic enterobacteria were tested by PCR for the presence of beta-lactamase genes: beta-lactamase genes encoding enzymes of the AmpC group (MOX, CMY, LAT, BIL, DHA, ACC, MIR, ACT, FOX), TEM, SHV, OXA‑1, ESBL genes of the CTX–M group, genes of carbapenemases (KPC, OXA‑48) and metal-beta-lactamases (VIM, IMP, NDM).Results. Most cases (81 %) of UTIs in women in St. Petersburg were due to enterobacteria, with Escherichia coli highly prevailing (66 %). Fosfomycin, meropenem and nitrofurantoin had the highest in vitro activity against uropathogenic Enterobacteriaceae. High rates of resistance to betalactam antibiotics were found (from 16 % to cefotaxime to 28 % to amoxicillin/clavulanic acid). The genes of TEM-beta-lactamases were found in 31 isolates (26.7 %), SHV – in 17 (14.6 %), CTX–M type – in 15 (12.9 %), DHA – in 2 (1.7 %). The other beta-lactam resistance genes (MOX, CMY, LAT, BIL, ACC, MIR, ACT, FOX, KPC group, OXA-like group, VIM, IMP, NDM) were not detected.Conclusion. Microbiological and molecular analysis of the structure of beta-lactam resistance is important for the effective of epidemiological control of antimicrobial resistance in pathogens causing urinary tract infections.

Evaluation of an edible polyherbal formulation against urinary tract infection pathogens, its antioxidant and anti-inflammatory potential

Nature has bestowed valuable gifts from plants that serve mankind with food and medicine. The folklore systems of medicine has led to a scientific revolution in various fields of nutraceutics and phytopharmacotherapy. The use of polyherbal formulations have also not been scientifically proven yet for their active principles. Thus the study was framed to analyze an edible standardized polyherbal formulation which is consumed by women especially where the requirement of dietary food supplements increases during the parturition and postpartum period to fight Urinary tract infections. The formulation was analysed showing presence of secondary metabolites higher in ethyl acetate extract for phenolics (346.88 ± 35.53 mg GAE/g extract), tannins (100.32 ± 3.23 mg TAE/g extract) and flavonoids (53.17 ± 4.58 mg QE/g extract). Efficient activity was found in methanol extract with 98.63% inhibition (DPPH scavenging potential); 117.67 ± 1.17 mM Fe (II) E/g extract (FRAP assay) and 87.55 ± 5.62 μM TEAC/g extract (ABTS scavenging potential) in hexane extract. Also found to have 36.54% inhibition in water extract for anti-inflammatory activity. The ethyl acetate extract of the formulation readily proves to be highly effective against pathogens such as Escherichia coli (ZOI- 19 ± 1 mm; MIC- 100 μg/ml; MBC- 125 μg/ml), Klebsiella pneumoniae (ZOI- 9.5 ± 0.5; MIC- 450 μg/ml; MBC- 475 μg/ml) and Proteus mirabilis (10.5 ± 1.32; MIC- 375 μg/ml; MBC- 400 μg/ml), however methanol extract was highly significant against Pseudomonas aeroginosa. The results were evident for the nutritional, antioxidant, anti-inflammatory and antimicrobial potential of the polyherbal formulation.

Common Pathogen and their Drug Sensitivity Pattern in Urinary Tract Infection at Chandka Medical College Hospital Larkana

Objective: To study the pattern of existing common pathogen of Urinary Tract Infection and their drug sensitivity pattern. Methods: It was a cross sectional study held in Medical Unit-I, CMC Teaching Hospital, Shaheed Mohtarma Benazir Bhutto Medical University(SMBBMU), Larkana with collaboration of Pathology Laboratory CMC Larkana, Aga Khan University Hospital Lab, Rahila Research Lab and Chughtai Lab. All the participants meeting inclusion criteria were enrolled. The reports of Urine culture were collected from above mentioned laboratories which include bio data, causative organism, their count and drug sensitivity pattern. The results were copied on proforma by researcher himself. SPSS version 25 was applied for data analysis. Results: Total 302 participants were registered in the study. Out of them 75.8% of them were female and 24.2% were male. Mean age of the patients was 40 ± 9 years. E-coli was found in 52.3%, Enterococcus in 13.2% and Klebsiella pneumonia in 9.6% cases. Meropenem was found sensitive in 92.4%, while cefoperazone sulbactam, Amikacin and Fosfomycin were found to be sensitive in 86.6%, 85%, 76.2% respectively. Ampicillin and Vancomycin was used in 50 cases for Enterococci. Ampicillin was found sensitive in 70% of cases where as vancomycin was found sensitive in 100% of cases with no vancomycin resistant Enterococci. For Enterobacteria Moxifloxacin was found resistant in 84.4% of cases, Ampicillin in 83.5%, Nalidix acid in 78% cases. While Ceftazidime and Amoxiclav was found resistant in 71.1% and 54.1% respectively. Conclusion: E-coli, Enterococcus and klabsella were the most pathogens found in this study. The drug sensitivity pattern showed that Meropenem, Cefoperazone Sulbactam, Amikacin, Fosfomycin and Vancomycin were found commonly sensitive while Moxifloxacin, Ampicillin, Ceftazidime and Amoxiclav was found resistant. Keywords: Urinary Tract Infection, Culture and Sensitivity, Meropenem, Vancomycin, Cefoperazone Sulbactam CMC @ SMBBMU, Larkana.

Species distribution of Enterobacteriaceae and non-Enterobacteriaceae responsible for urinary tract infections at the Zainoel Abidin Hospital in Banda Aceh, Indonesia

Abstract. Suhartono S, Mahdani W, Hayati Z, Nurhalimah N. 2021. Species distribution of Enterobacteriaceae and non-Enterobacteriaceae responsible for urinary tract infections at the Zainoel Abidin Hospital in Banda Aceh, Indonesia. Biodiversitas 22: 3313-3318. Urinary tract infection (UTI) is an infection that occurs along the urinary tract caused by pathogenic bacteria. Enterobacteriaceae and non-Enterobacteriaceae are generally normal flora originating from the large intestine and vaginal mucosa. This study aimed to assess the distribution of Enterobacteriaceae and non -Enterobacteriaceae pathogens that cause UTI based on species diversity, patient age, gender, and hospital units, and to evaluate their antibiotic sensitivity to uropathogens in ZAH. In total, there were 284 isolates classified as UTI pathogens with 178 Enterobacteriaceae isolates dominated by Escherichia coli and 107 non- Enterobacteriaceae isolates. Non- Enterobacteriaceae consisted of 77 isolates of Gram-positive dominated by Enterococcus faecalis and Enterococcus facium, and 29 isolates of Gram-negative dominated by Acinetobacter baumannii. The highest UTI ratio was found in the elderly (56-65 years), namely 66.2% Enterobacteriaceae and 33.8% non-Enterobacteriaceae isolates. Based on gender, females were infected with Enterobacteriaceae (66.86%) and non-Enterobacteriaceae (37.41%). Most of UTI patients in the internal medicine unit were infected with Enterobacteriaceae (55.36%) and non-Enterobacteriaceae (44.64%). Amikacin, meropenem, and levofloxacin were antibiotics that had high sensitivity against Enterobacterial and non-Enterobacterial uropathogens. The emergence of Gram-positive uropathogens need to be concerned as these groups start emerging. It is also important to monitor regularly the antibiotic susceptibility of bacterial UTI pathogens to ensure the efficacy of current UTI treatments and minimize the UTI incidence in nosocomial settings.

Production of Silver Nanoparticles from Carum copticum Plant Extract and Identification of its Antimicrobial Activity

The nanotechnology develops well in the green synthesis of silver nanoparticles from the plants and microorganisms. Recently, silver nanoparticles were used against of disease management and its control measures. Various plants and its extract were used to synthesis of silver nanoparticles and these particles were identified by some advance techniques such as ultraviolet analysis, high-performance liquid chromatography analysis, X-ray diffraction, Fourier transform infrared, transmission electron microscopy, and scanning electron microscopy. These techniques were used for shape, size, and character analysis of the silver nanoparticles. In this work, silver nanoparticles were used to identify its potential antimicrobial against of urinary tract infection (UTI) pathogens which are produced extended-spectrum beta-lactamases. Both Gram-positive and Gram-negative bacteria will produce the UTI and in this work Klebsiella sp. used.

Видовой состав возбудителей оппортунистических инфекций мочевыводящих путей и возможности преодоления их антибиотикорезистентности

The etiological structure of opportunistic infections of the urinary tract represented by bacteria of the Enterobacteriaceae family (with a predominance of Escherichia coli, Klepsiella pneumoniae), as well as non-fermenting gram-negative bacteria (Acinetobacter baumanii, Pseudomonas) and staphylococci and enterococcus etc. were revealed in the result of the research. The antibiotic sensitivity of urinary tract infection pathogens to the most commonly used antibiotics were studied, also the antibiotic resistance of E. coli and K. pneumoniae to co-trimoxazole, fluoroquinolones, carbapenems, cephalosporins of the 1st and 2nd generation and resistance of A. baumanii and P. aeruginosa to fluoroquinolones, carbapenems, as well as VRE and MRSA were studied. The study and selection of new herbal medicines were carried out. The 10% solution of Geranium collinum Steph and Rosmarinus officinalis L. had the highest microbiological properties which can be used in the treatment of urinary tract infection.

Bacterial Pathogens in Urinary Tract Infection and Their Antibiotic Susceptibility Pattern

Objective: Studies on prevalence of common bacterial pathogens causing UTIs in North India and their antibiotic susceptibility patterns against particular drugs. Materials and methods: A retrospective study conducted in UTI patients attending Dr Lal Path Labs, NRL, Delhi from March 2019 to December 2020. Clean catch midstream urine specimens collected for urine culture and sensitivity tests. Identification carried out by MALDI-TOF and antimicrobial susceptibility evaluated by VITEK® 2 with respective susceptibility cards (AST 280, 281, P628 Biomerieux, India) as per CLSI M100-S-30. Results and Discussion: In a period of 21 months observation, 65,619/2, 72,000 (24.1%) cases were positive to various clinical analyses of urine. Among them 40,568 (61.8%) were females and 25051(38.2%) were males. Female to male infection was 1.6:1. The age wise study of the culture positive cases indicates that the UTI infection occurs from infants (0 year) to elderly people (>=60 years). The 61.1% of the UTIs attributed by E.coli followed by K. pneumoniae (20.3%), Enterococcus faecalis (7.1%), Pseudomonas aeruginosa (5.4%), Proteus mirabilis (2.8%), Enterobacter cloacae (1.6%) Acinetobacter baumannii (1.1%) and Staphylococcus aureus (0.8%). Drug-sensitivity patterns suggest that the most susceptible antibiotic was Amikacin and Penems. However, penicillin derivatives, commonly prescribed advanced-generation cephalosporins, fluoroquinolones have found the most resistant drug among common uropathogens. Conclusion: Our study highlights the epidemiological trend of common bacterial pathogens causing UTIs and promotes information in order to establish the correct use of antibiotics. This study concluded that Gram-negative and Gram-positive uropathogens showed alarming rates of resistance for penicillin derivatives, advanced-generation cephalosporins, fluoroquinolones, and nitrofurantoin, while Amikacin, Penem group and Tigecycline seems the only suitable antimicrobials that could help clinicians in starting rational empirical antibiotic therapy.

Extraction of Chitosan from Crab Shell and Fungi and Its Antibacterial Activity against Urinary Tract Infection Causing Pathogens

In this study, shells of sea crab and fungus Aspergillus niger were subjected for chitosan extraction which has been done following demineralization, deproteination and deacetylation. Chitosan yield from crab shell and fungi was 37.5% and 39.3% respectively and water binding capacity was 58.44% and 60.21% respectively. The extracted chitosan was characterized using Fourier transform infrared spectroscopy (FTIR) and subjected for antibacterial activity against Urinary tract infection (UTI) pathogens – Klebsiella pneumoniae, Proteus mirabilis and E. coli. Chitosan of crab shell showed better antibacterial activity than fungal derived chitosan. Chitosan gel was prepared using the extracted chitosan where it was also showing good antibacterial activity.

Evaluation of clinical, etiological and antimicrobial resistance profile of pediatric urinary tract infections in a secondary health care centre.

Urinary tract infections are common during childhood. The etiologic agents and empirical antibiotics may vary due to age and geographic area. This study was designed to investigate the urinary tract infection pathogens, their antibiotic resistance profile and risk factors in a sample of well-child population. This retrospective study was conducted in the pediatric clinics of a secondary health-care centre in a one-year period. The source of data was hospital and laboratory records. Toilet trained children and adolescents aged between 5-17 years old with positive urine culture were enrolled into the study. Microbiological studies were conducted according to international guidelines. During the study 3640 urine samples were analyzed and 342(9.4%) had significant growth. Gram negative enterobacteria were the most common infectious agents. Antibiotic susceptibility tests showed low cephalosporine resistance unless ESBL was positive. Multi drug resistance was remarkable. Extended beta lactamase resistance rate was 17%. Previous history of antibiotic use before the present administration was the only significant risk factor for ESBL positivity. Treating urinary tract infections may become an emerging problem soon. Unless there are risk factors, cephalosporines are good options, but if so nitrofurantoin or carbapanems should be preferred for treatment in this population.

On-cell saturation transfer difference NMR for the identification of FimH ligands and inhibitors

We describe the development of an on-cell NMR method for the rapid screening of FimH ligands and the structural identification of ligand binding epitopes. FimH is a mannose-binding bacterial adhesin expressed at the apical end of type 1 pili of uropathogenic bacterial strains and responsible for their d-mannose sensitive adhesion to host mammalian epithelial cells. Because of these properties, FimH is a key virulence factor and an attractive therapeutic target for urinary tract infection.We prepared synthetic d-mannose decorated dendrimers, we tested their ability to prevent the FimH-mediated yeast agglutination, and thus we used the compounds showing the best inhibitory activity as models of FimH multivalent ligands to set up our NMR methodology. Our experimental protocol, based on on-cell STD NMR techniques, is a suitable tool for the screening and the epitope mapping of FimH ligands aimed at the development of new antiadhesive and diagnostic tools against urinary tract infection pathogens. Notably, the study is carried out in a physiological environment, i.e. at the surface of living pathogen cells expressing FimH.