Urinary Tract Pathogens Research Articles

Comparative in vitro inhibition of urinary tract pathogens by single- and multi-strain probiotics

Multi-species probiotic preparations have been suggested as having a wide spectrum of application, although few studies have compared their efficacy with that of individual component strains at equal concentrations. We therefore tested the ability of 4 single probiotics and 4 probiotic mixtures to inhibit the urinary tract pathogens Escherichia coli NCTC 9001 and Enterococcus faecalis NCTC 00775. We used an agar spot test to test the ability of viable cells to inhibit pathogens, while a broth inhibition assay was used to assess inhibition by cell-free probiotic supernatants in both pH-neutralised and non-neutralised forms. In the agar spot test, all probiotic treatments showed inhibition, L. acidophilus was the most inhibitory single strain against E. faecalis, L. fermentum the most inhibitory against E. coli. A commercially available mixture of 14 strains (Bio-Kult(®)) was the most effective mixture, against E. faecalis, the 3-lactobacillus mixture the most inhibitory against E. coli. Mixtures were not significantly more inhibitory than single strains. In the broth inhibition assays, all probiotic supernatants inhibited both pathogens when pH was not controlled, with only 2 treatments causing inhibition at a neutral pH. Both viable cells of probiotics and supernatants of probiotic cultures were able to inhibit growth of two urinary tract pathogens. Probiotic mixtures prevented the growth of urinary tract pathogens but were not significantly more inhibitory than single strains. Probiotics appear to produce metabolites that are inhibitory towards urinary tract pathogens. Probiotics display potential to reduce the incidence of urinary tract infections via inhibition of colonisation.

Comparative evaluation of Vitek 2 identification and susceptibility testing of urinary tract pathogens directly and isolated from chromogenic media

We evaluated the use of urine specimens for direct identification and antibiotic testing of urinary tract pathogens using the Vitek system. A total of 343 urine specimens from patients with suspected UTI were selected by pyuria and screened by Gram staining to detect bacteriuria. Of those, 132 were analysed after Gram staining, showing a high number of micro-organisms of a single morphological type. Direct susceptibility testing and identification were performed by using the Vitek system. Results were compared using the standard inoculation method based on the incubation of solid media. After sub-culture, 107 specimens grew a significant count of a single species and were used for the comparative analysis. The direct method correctly identified 88 isolates (82.3 %). When compared according to antibiotic susceptibility testing, the error rate was 2.4 % overall with 0.2 % very major, 0.4 % major and 1.8 % minor errors. 84.7 % of the Gram-negative bacilli had a complete susceptibility report in ≤ 8 h. This method offers the advantage of prompt processing and earlier reporting of complete results for positive urine specimens.

Comparison of antibiotic resistance patterns in collections of Escherichia coli and Proteus mirabilis uropathogenic strains

Escherichia coli and Proteus mirabilis are important urinary tract pathogens. The constant increase in the antibiotic resistance of clinical bacterial strains has become an important clinical problem. The aim of this study was to compare the antibiotic resistance of 141 clinical (Sweden and Poland) and 42 laboratory (Czech Republic) P. mirabilis strains and 129 clinical (Poland) uropathogenic E. coli strains. The proportion of unique versus diverse patterns in Swedish clinical and laboratory P. mirabilis strain collections was comparable. Notably, a similar proportion of unique versus diverse patterns was observed in Polish clinical P. mirabilis and E. coli strain collections. Mathematical models of the antibiotic resistance of E. coli and P. mirabilis strains based on Kohonen networks and association analysis are presented. In contrast to the three clinical strain collections, which revealed complex associations with the antibiotics tested, laboratory P. mirabilis strains provided simple antibiotic association diagrams. The monitoring of antibiotic resistance patterns of clinical E. coli and P. mirabilis strains plays an important role in the treatment procedures for urinary tract infections and is important in the context of the spreading drug resistance in uropathogenic strain populations. The adaptability and flexibility of the genomes of E. coli and P. mirabilis strains are discussed.

Antimicrobial resistance patterns among urinary tract pathogens in childhood

Objective. To examine the resistance rates among uropathogens against commonly used antimicrobials that are prescribed for pediatric urinary tract infections and to compare resistance rates between the study periods. Methods. A retrospective analysis of the antibiotic resistance of microorganisms included the microorganisms isolated from 127 children under the age of six. All children presented with their first symptomatic community-acquired urinary tract infection and were admitted for treatment at the Pediatrics Clinic, Clinical Center 'Kragujevac', Serbia, between 2006 to 2010. Results: The highest rates of resistance of uropathogens were found to ampicillin (35.4%), gentamicin (33.1%) and trimethoprim-sulfamethoxazole (27.6%). Concerning resistance rates were identified to third-generation cephalosporins (37.0%), where most bacteria were resistant to ceftriaxone (15.7%). Resistance to first-generation cephalosporins also caused concern (29.9%), and most pronounced was the resistance to cephalexin (26.8% of the total number of bacteria isolated). Resistance to amikacin was identified in 18.9% of cases. There was no significant difference in resistance rates between those isolates observed in 2006 and 2010. Conclusions. Having in mind high resistance rates of common antimicrobials, we recommend prescription of different or less frequently used antibiotics. Amoxicillin is still a good first choice for treating uncomplicated urinary infections in children aged one year and older. The use of parenteral treatment in children with their first urinary tract infection is appropriate only initially until antimicrobial sensitivity is available and in complicated cases of the disease.

Incidence of Urinary Tract Infections and Its Aetiological Agents among Pregnant Women in Karnataka Region

Urinary tract infection (UTI) is the most common medical complications of pregnancy together with anaemia and hypertension and it occurs approximately in 5% - 10% of all pregnancies. The aim of this study was to determine the incidence of UTI and prevalence of uropathogens among pregnant women. During the study period from December 2009 to August 2010, 417 urine samples were analyzed. UTI was diagnosed by growth of at least 10 5 CFU/ml of a urinary tract pathogen in a culture of a midstream urine sample. The isolated bacteria were identified by biochemical tests. The results showed that 49.4% of pregnant women have UTI. E. coli which was the most frequently isolated organism (56.79%), followed by Klebsiella sps (19.9%), Pseudomonas sps (6.3%), and Proteus sps (5.8%). Other pathogens isolated were Enterobacter (3.8%), Citrobacter (1.4%) and Enterococcus sps (0.9%). Of the variables examined, the highest prevalence rate was observed where, 53.3% of the infected women were in the age group 36 to 40 years, 54.15% were in their 3 rd trimester; also the highest infection rate (70.2%) was observed in 7 th month of pregnancy, concluding that old age pregnancy increased parity prone for UTI apart from individual hygiene and economical status.

Antimicrobial resistance in pathogens causing urinary tract infections in a rural community of Odisha, India

Background:Antimicrobial resistance of urinary tract pathogens has increased worldwide. Empiric treatment of community-acquired urinary tract infection (CA-UTI) is determined by antimicrobial resistance patterns of uropathogens in a population of specific geographical location.Objectives:This study was conducted to determine the prevalence of CA-UTI in rural Odisha, India, and the effect of gender and age on its prevalence as well as etiologic agents and the resistance profile of the bacterial isolates.Materials and Methods:Consecutive clean-catch mid-stream urine samples were collected from 1670 adult patients. The urine samples were processed and microbial isolates were identified by conventional methods. Antimicrobial susceptibility testing was performed on all bacterial isolates by Kirby Bauer's disc diffusion method.Results:The prevalence of UTI was significantly higher in females compared with males (females 45.2%, males 18.4%, OR = 2.041, 95% CI = 1.64-2.52, P ≤ 0.0001). Young females within the age group of 18-37 years and elderly males (≥68 years) showed high prevalence of UTI. Escherichia coli (68.8%) was the most prevalent isolate followed by Enterococcus spp. (9.7%). Amikacin and nitrofurantoin were the most active antimicrobial agents which showed low resistance rate of 5.8% and 9.8%, respectively.Conclusion:Our study revealed E. coli as the pre-dominant bacterial pathogen. Nitrofurantoin should be used as empirical therapy for uncomplicated CA-UTIs. In the Indian setting, routine urine cultures may be advisable, since treatment failure is likely to occur with commonly used antimicrobials. Therefore, development of regional surveillance programs is necessary for implementation of national CA-UTI guidelines.

Activity of Proteus mirabilis FliL Is Viscosity Dependent and Requires Extragenic DNA

Proteus mirabilis is a urinary tract pathogen and well known for its ability to move over agar surfaces by flagellum-dependent swarming motility. When P. mirabilis encounters a highly viscous environment, e.g., an agar surface, it differentiates from short rods with few flagella to elongated, highly flagellated cells that lack septa and contain multiple nucleoids. The bacteria detect a surface by monitoring the rotation of their flagellar motors. This process involves an enigmatic flagellar protein called FliL, the first gene in an operon (fliLMNOPQR) that encodes proteins of the flagellar rotor switch complex and flagellar export apparatus. We used a fliL knockout mutant to gain further insight into the function of FliL. Loss of FliL results in cells that cannot swarm (Swr(-)) but do swim (Swm(+)) and produces cells that look like wild-type swarmer cells, termed "pseudoswarmer cells," that are elongated, contain multiple nucleoids, and lack septa. Unlike swarmer cells, pseudoswarmer cells are not hyperflagellated due to reduced expression of flaA (the gene encoding flagellin), despite an increased transcription of both flhD and fliA, two positive regulators of flagellar gene expression. We found that defects in fliL prevent viscosity-dependent sensing of a surface and viscosity-dependent induction of flaA transcription. Studies with fliL cells unexpectedly revealed that the fliL promoter, fliL coding region, and a portion of fliM DNA are needed to complement the Swr(-) phenotype. The data support a dual role for FliL as a critical link in sensing a surface and in the maintenance of flagellar rod integrity.

Antibiotic Susceptibility of Bacterial Strains Isolated From Urinary Tract Infections in Karaj, Iran

Backgrounds: Urinary Tract Infection (UTI) is one of the most common bacterial diseases worldwidethat can be presented asymptomatic or symptomatic, characterized by a wide range of symptoms from mild irritative voiding to bacteremia, sepsis, or even death. In latter decades, widespread utilization of antibiotics has resulted in increased incidence of antibiotic resistance among urinary tract pathogens all over the world. Objectives: The aim of this study was to determine patterns of antibiotic resistance bacteria isolated from urinary tract infections in the city of Karaj, Iran. Materials and Methods: This descriptive study was conducted in the city of Karaj from November 2009 to August 2010. Bacterial isolates were identified by standard biochemical tests. Antibacterial susceptibility test was performed by Kirby-Bauer method against some common antibiotics for Gram negative and Gram positive bacteria and the data were analyzed by SPSS software, version 12.0.1. Results: In this study, 230 (8.06%)out of 2852 patients showed positive urine cultures of which there were 204 (88.69%) females and 26 (11.3%) males. 180 (83.17%) cases of isolated bacteria were Gram negative bacilli while 50 (21.73%) cases were Gram positive cocci. E. coli isolates, as the most frequent Gram negative bacteria, showed high resistance to cephalothin (88.16%) and high susceptibility to nitrofurantoin (90.78%). Also Staphylococcus saprophyticus isolates, as the most frequent Gram positive bacteria, exhibited high resistance to ampicillin, tetracycline, and erythromycin (92.31%) and high susceptibility to nitrofurantoin and vancomycin (92.3%). Conclusions: considering the results of this study, E.coli isolates were the predominant pathogens in UTI. Our data demonstrated that antibiotics with the highest activity included ciprofloxacin and nitrofurantoin and those with the least activity included ampicillin and sulfamethoxazole-trimethoprim. Our findings reinforce the need for ongoing investigations to show the trends of antibiotic resistance which can help antibiotic prescription in the clinics.

Sensitivity Pattern of Urinary Tract Pathogens to Anti-microbial Drugs at a Tertiary Level Hospital in Bangladesh

Urinary tract infections (UTIs) are some of the most common infections experienced by human. It is also the most common cause of nosocomial infections in adults. The aim of this study was to determine the bacteriological pattern and their sensitivity to commonly used antimicrobial drugs in urinary tract infection in Bangladesh. This was a prospective study conducted in Microbiology department of Dhaka National Medical College, a tertiary level teaching hospital in Dhaka, Bangladesh. A total of 216 culture positive urine samples were examined. Female patient were found to be more 65.7% than male 34.3%. Maximum patients were from 20-35 yrs. age group. The most common isolate was E.coli 84.3%. These E.coli is more sensitive to Imipenem 93.98%, Amikacin 90.52%, Nitrofurantoin 78.88% Ceftazidim 78.26%, Ciprofloxacin 70.67%, Cefuroxime 65.49%,Ofloxacin 60.83%, Ceftriaxone 59.03% and Cephradin 56.96%. Resistance is more in case of amoxicillin 82.41%, Doxycycline 72.42%, Cefixime 58.70% and Nalidixic Acid 57.02%. DOI: http://dx.doi.org/10.3329/jdnmch.v17i1.12186 J. Dhaka National Med. Coll. Hos. 2011; 17 (01): 18-21

Reduction in Hospital Admission Rates Due to Post-Prostate Biopsy Infections After Augmenting Standard Antibiotic Prophylaxis

We evaluated the incidence of infectious complications requiring hospitalization after transrectal ultrasound guided prostate biopsy, comparing an augmented regimen of antibiotic prophylaxis to the standard regimen, and established cost-effectiveness at our center. Our standard antibiotic prophylaxis regimen consisted of 3 days of ciprofloxacin or Bactrim™ DS in the perioperative period. An increase in hospital admissions related to infection after transrectal ultrasound guided biopsy from January 2010 through December 2010 led us to initiate an augmented regimen of 3 days of ciprofloxacin or Bactrim DS in addition to 1 dose of intramuscular gentamicin before biopsy from January 2011 to December 2011. Urine and blood cultures along with bacterial susceptibilities were obtained at admission and compared between the 2 groups. Cost analysis was done to determine the cost-effectiveness of standard and augmented regimens. The rate of hospitalization due to post-biopsy infections was 3.8% (11 patients among 290 biopsies) in 2010, which decreased to 0.6% (2 patients among 310 biopsies) in 2011 (p <0.001). Of the admitted patients who received standard prophylaxis, 73% had fluoroquinolone resistant Escherichia coli urinary infection and/or bacteremia and only 9% had strains resistant to gentamicin. Multivariate analysis showed that the standard regimen was significantly associated with hospital admission due to post-biopsy infection (HR 2.078 ± 0.84, p = 0.013). The augmented regimen resulted in a cost savings of $15,700 per 100 patients compared to the standard regimen. The addition of gentamicin to current prophylactic regimens significantly reduced the rate of hospitalization for post-biopsy infectious complications and was shown to be cost-effective.

Evaluating clinical indications for continued catheterisation

Evaluating clinical indications for continued catheterisation

Acute hepatitis induced by fosfomycin: A case report and review of the literature

Fosfomycin is a broad spectrum antibiotic, belonging to the group of phosphonic acid antibiotics that is active against most urinary tract pathogens. It is an effective and safe antibiotic for the treatment of uncomplicated urinary tract infections, which makes it a frequently used drug in our country in this clinical setting. In general, it is well-tolerated and does not appear to cause serious reactions. Most reactions are gastrointestinal. Hepatotoxicity with this drug has been rarely described.We report a case of acute hepatitis induced by a single 3g dose of fosfomycin, in a previously healthy female adult.

Is there a direct antimicrobial effect of botulinum neurotoxin type A?

Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Several studies describe a reduction of symptomatic urinary tract infections in patients with neurogenic detrusor overactivity after intradetrusor injections of botulinum neurotoxin A (BoNT/A). It was, however, unclear if a direct antibacterial effect of BoNT/A plays a role in this clinical observation. This is the first study to investigate a potential antibacterial effect of two frequently used BoNT/A formulations (i.e. Botox® and Dysport®), providing evidence that BoNT/A does not exert an antibacterial effect on lower urinary tract pathogens. • To determine a potential direct antimicrobial effect of botulinum neurotoxin type A (BoNT/A). • A prospective study was carried out using onabotulinumtoxin A (Botox®) and abobotulinumtoxin A (Dypsort®) in agar diffusion and broth microdilution assays with various clinical urinary tract isolates (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Acinetobacter baumannii, Citrobacter freundii, Klebsiella oxytoca and Bacillus subtilis). • Inhibition zones (mm) of bacteria around a disc containing 20 µL saline with 4 IU of Botox® were measured in the agar diffusion assay. • Minimal inhibitory concentrations (MICs, IU/mL) of both toxins for all bacteria were determined in the broth microdilution assay after overnight incubation at 35 °C. • There was no inhibition zone in the agar diffusion assays with any bacterial strain. • The microdilution test using Botox® and Dysport® showed bacterial growth in all dilutions, i.e. MICs > 20 and >100 IU/mL for Botox® and Dysport®, respectively. • BoNT/A has no direct antimicrobial effect. • The reduced frequency of symptomatic urinary tract infections (sUTIs) in patients with neurogenic detrusor overactivity (NDO) after BoNT/A intradetrusor injections seems to be caused by different indirect mechanisms, which are still not completely understood.

Standardization of isothermal microcalorimetry in urinary tract infection detection by using artificial urine

Isothermal microcalorimetry (IMC) has recently been reported as a new method to rapidly detect urinary tract pathogens (UTP). However, further application of microcalorimetry in the clinical setting requires a standardized procedure. An important step toward such standardization is to use a reproducible growth medium. In this study, we investigated the potential of artificial urine in combination with microcalorimetry for detection of common UTP. A microcalorimeter equipped with 48 channels was used. Detection was accomplished, and growth was monitored for four bacterial strains in artificial urine at 37 °C by measuring metabolic heat flow (μW = μJ/s) as a function of time. The strains were Escherichia coli, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus aureus. Bacterial growth was detected after 3-32 h with decreasing inoculums down to 1 CFU. The gram-negative strains grew and were detected faster than their gram-positive counterparts. The growth rates the different strains were 0.75 ± 0.11 for E. coli, 0.74 ± 0.10 for E. faecalis, 1.31 ± 0.04 for P. mirabilis, and 0.56 ± 0.20 for S. aureus. The shape of individual heat flow curves was characteristic for each species independent of its initial concentration. IMC allows rapid detection of UTP in artificial urine. Clearly, different heat flow patterns enable accurate pathogen differentiation. UTP detection after only 4 h is realistic. The rapid detection of UTP tested in standardized artificial urine proves the diagnostic potential of IMC and warrants further microcalorimetric studies in the clinical setting of urinary tract infections.

Chemical composition and antibacterial activity of Indian seagrasses against urinary tract pathogens

Seagrasses have a long history of being used for a variety of remedial purposes, such as the fever, skin diseases, muscle pains, wounds and stomach problems. Hence it is essential to study their bioactive metabolites and medicinal properties when considering their food applications. The chemical composition of six seagrasses were determined and evaluated for their potential to urinary tract infection bacteria (UTI). The chemical composition determined by GC–MS yielded 24 compounds. For the first time 4H-Pyran-4-one-2,3-dihydro-3,5-dihydroxy-6-methyl- (6.68%), d-allose (3.67%) and 5-Caranol, trans,trans-(+)- (2.14%) were identified from Halodule pinifolia. d-Allose is a aldo-hexose (sugar) used as a potential inhibitor of glycosidases and low-calorie carbohydrate sweeteners. Among the six seagrasses tested, H. pinifolia and Cymodocea rotundata exhibited predominant growth inhibitory activity against all the UTI bacteria. This study shows the presence of various biological metabolites in tested seagrasses that can be used effectively in food and pharmacological industries.

The relative importance of Staphylococcus saprophyticus as a urinary tract pathogen: distribution of bacteria among urinary samples analysed during 1 year at a major Swedish laboratory

To determine the distribution of urinary tract pathogens with focus on Staphylococcus saprophyticus and analyse the seasonality, antibiotic susceptibility, and gender and age distributions in a large Swedish cohort. S. saprophyticus is considered an important causative agent of urinary tract infection (UTI) in young women, and some earlier studies have reported up to approximately 40% of UTIs in this patient group being caused by S. saprophyticus. We hypothesized that this may be true only in very specific outpatient settings. During the year 2010, 113,720 urine samples were sent for culture to the Karolinska University Hospital, from both clinics in the hospital and from primary care units. Patient age, gender and month of sampling were analysed for S. saprophyticus, Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis. Species data were obtained for 42,633 (37%) of the urine samples. The most common pathogens were E. coli (57.0%), Enterococcus faecalis (6.5%), K. pneumoniae (5.9%), group B streptococci (5.7%), P. mirabilis (3.0%) and S. saprophyticus (1.8%). The majority of subjects with S. saprophyticus were women 15-29 years of age (63.8%). In this age group, S. saprophyticus constituted 12.5% of all urinary tract pathogens. S. saprophyticus is a common urinary tract pathogen in young women, but its relative importance is low compared with E. coli even in this patient group. For women in other ages and for men, growth of S. saprophyticus is a quite uncommon finding.

Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at University of Gondar Teaching Hospital, Northwest Ethiopia

BackgroundUrinary tract infection (UTI) is a common health problem among pregnant women. Proper investigation and prompt treatment are needed to prevent serious life threatening condition and morbidity due to urinary tract infection that can occur in pregnant women. Recent report in Addis Ababa, Ethiopia indicated the prevalence of UTI in pregnant women was 11.6 % and Gram negative bacteria was the predominant isolates and showed multi drug resistance. This study aimed to assess bacterial profile that causes urinary tract infection and their antimicrobial susceptibility pattern among pregnant women visiting antenatal clinic at University of Gondar Teaching Hospital, Northwest Ethiopia.MethodsA cross-sectional study was conducted at University of Gondar Teaching Hospital from March 22 to April 30, 2011. Mid stream urine samples were collected and inoculated into Cystine Lactose Electrolyte Deficient medium (CLED). Colony counts yielding bacterial growth of 105/ml of urine or more of pure isolates were regarded as significant bacteriuria for infection. Colony from CLED was sub cultured onto MacConkey agar and blood agar plates. Identification was done using cultural characteristics and a series of biochemical tests. A standard method of agar disc diffusion susceptibility testing method was used to determine susceptibility patterns of the isolates.ResultsThe overall prevalence of UTI in pregnant women was 10.4 %. The predominant bacterial pathogens were Escherichia coli 47.5 % followed by coagulase-negative staphylococci 22.5 %, Staphylococcus aureus 10 %, and Klebsiella pneumoniae 10 %. Gram negative isolates were resulted low susceptibility to co-trimoxazole (51.9 %) and tetracycline (40.7 %) whereas Gram positive showed susceptibility to ceftriaxon (84.6 %) and amoxicillin–clavulanic acid (92.3 %). Multiple drug resistance (resistance to two or more drugs) was observed in 95 % of the isolates.ConclusionSignificant bacteriuria was observed in asymptomatic pregnant women. Periodic studies are recommended to check the outcome of asymptomatic bacteriuria and also monitor any changes in the susceptibility patterns of urinary tract pathogens in pregnant women.

Rapid detection of urinary tract pathogens using microcalorimetry: principle, technique and first results

What's known on the subject? and What does the study add? Microcalorimetry has been applied in several microbiological studies, but never in a clinical urological context. In addition, basic knowledge on the growth of urinary pathogens in urine is still scarce and data regarding the growth rate of many urinary pathogens in urine are still not available. The study demonstrates that this innovative application of microcalorimetry is useful in (i) investigating the growth of urinary pathogens in sterilized urine and (ii) as a rapid tool for diagnosis of urinary infection as well as for further identification of the causative infectious agent. To investigate the value of isothermal microcalorimetry (IMC) in the detection and differentiation of common urinary tract pathogens in urine. IMC is a non-specific analytical tool for the measurement of heat in the microwatt range. A microcalorimeter equipped with 48 channels was used. Detection was accomplished, and growth was monitored for four bacterial strains in sterilized urine at 37 °C by measuring metabolic heat flow (µW = µJ/s) as a function of time. The strains were Escherichia coli, Proteus mirabilis, Enterococcus faecalis and Staphylococcus aureus. Bacterial growth was detected after 3.1 to 17.1 h with decreasing inocula. The detection limit was 1 colony-forming unit (CFU)/mL for E. coli, 10 CFU/mL for P. mirabilis and E. faecalis and 10(3) CFU/mL for S. aureus. The total heat was highest in P. mirabilis ranging from 10 to 12 J, followed by E. coli (3-4 J), S. aureus (2-3 J) and E. faecalis (1.3-1.5 J). The shape of the heat flow curves was characteristic for each species independent of its initial concentration. IMC allows rapid detection of bacteriuria, much faster than conventional culture. Urinary tract pathogen detection after only 3.1 h is realistic. Clearly different heat flow patterns enable accurate pathogen differentiation. Due to expeditious identification of urine samples that contain only low colony counts (i.e. less than 10(3) CFU/mL), IMC may become a valuable screening tool for detecting the presence of significant bacteriuria.

Relationship between Urinary Tract Infection Categorization and Pathogens’ Antimicrobial Susceptibilities

Background: Urinary tract infections (UTIs) can be hard to treat and treatment plans need to include accurate categorization such as uncomplicated or complicated UTI, or catheterized or uncatheterized UTI. We investigated the antibiotic susceptibilities of representative uropathogens in UTI categories. Methods: We isolated uropathogens and analyzed their antimicrobial susceptibilities according to UTI categorization such as: (1) urology outpatients, urology inpatients, or other department inpatients; (2) uncomplicated or complicated UTIs; (3) upper or lower UTIs, and (4) non-catheterized or catheterized UTIs. Results:Escherichia coli, Enterococcus faecalis, and Pseudomonas aeruginosa were representative uropathogens. Susceptibilities to levofloxacin (LVFX) in E. coli in urology outpatients (p = 0.0179), those to ceftadizime in E. coli in other department inpatients (p = 0.0327), and those to LVFX in E. faecalis in complicated UTI (p = 0.0137) significantly decreased in these 3 years compared with the previous 3 years. Susceptibilities of upper UTI to LVFX in E. coli were significantly lower in the recent 4 years compared to lower UTI (p = 0.0452) and those of catheterized UTI to LVFX in E. faecalis were significantly lower than in non-catheterized UTI (p = 0.0153). Conclusions: Data demonstrated different tendencies of uropathogens’ antibiotic susceptibilities according to UTI categorizations and they could be useful for planning UTI treatments.

The Antibiotic Resistance Profiles of Bacterial Strains Isolated from Patients with Hospital-Acquired Bloodstream and Urinary Tract Infections

Treatment of nosocomial infections is becoming difficult due to the increasing trend of antibiotics resistance. Current knowledge on antibiotic resistance pattern is essential for appropriate therapy. We aimed to evaluate antibiotic resistance profiles in nosocomial bloodstream and urinary tract pathogens. A total of 129 blood stream and 300 urinary tract positive samples were obtained from patients referring to Besat hospital over a two-year period (2009 and 2010). Antibiotic sensitivity was ascertained using the Kirby-Bauer disk diffusion technique according to CLSI guidelines. Patient's data such as gender and age were recorded. The ratio of gram-negative to gram-positive bacteria in BSIs was 1.6 : 1. The most prevalent BSI pathogen was Coagulase-Negative Staphylococci (CoNS). The highest resistance rate of CoNS was against penicillin (91.1%) followed by ampicillin (75.6%), and the lowest rate was against vancomycin (4.4%). Escherichia coli was the most prevalent pathogen isolated from urinary tract infections (UTIs). Ratio of gram-negative to gram-positive bacteria was 3.2 : 1. The highest resistance rate of E. coli isolates was against nalidixic acid (57.7%). The present study showed that CoNS and E. coli are the most common causative agents of nosocomial BSIs and UTIs, and control of infection needs to be addressed in both antibiotic prescription and general hygiene.