Uropathogenic Microorganisms Research Articles

Множественная лекарственная устойчивость уропатогенов как фактор риска при оказании медицинской помощи (опыт Центральной Болгарии)

The emergence of resistance to multiple antimicrobial agents in uropathogenic bacteria has become a significant public health problem. These microorganisms are the cause of urinary tract infections, which are among the most frequently treated diseases in the outpatient medical care. A cross-sectional study was conducted among 353 outpatients over 18 years of age with positive urine sample culture. It involved measuring the index of multiple antibiotic resistance of uropathogens causing infections among individuals. The research was conducted in the period January – June 2023 at a private clinical laboratory center located in Stara Zagora, Bulgaria. One third of the isolates of E. coli and more than a half of those of Klebsiella pneumoniae had a measured MAR index greater than 0.2, with confirmatory high rates of resistance to aminopenicillins and cephalosporins. Alarmingly high MARI values were measured in all representatives of Enterococcus faecalis, Enterobacter species and Pseudomonas aeruginosa. These strains were also established to have high levels of resistance (varying from 58.3 to 100 %) to some of antimicrobial medicines most commonly prescribed in the outpatient healthcare. Findings of this study emphasize the importance and seriousness of the existing problem with the increasing prevalence of uropathogenic microorganisms with multiple resistance to oral antibiotics. This creates elevated risks of failure to provide effective treatment for patients.

Multidrug resistance of uropathogens as a risk factor in providing medical care to patients from central Bulgaria

The emergence of resistance to multiple antimicrobial agents in uropathogenic bacteria has become a significant public health problem. These microorganisms are the cause of urinary tract infections, which are among the most frequently treated diseases in the outpatient medical care. A cross-sectional study was conducted among 353 outpatients over 18 years of age with positive urine sample culture. It involved measuring the index of multiple antibiotic resistance of uropathogens causing infections among individuals. The research was conducted in the period January – June 2023 at a private clinical laboratory center located in Stara Zagora, Bulgaria. One third of the isolates of E. coli and more than a half of those of Klebsiella pneumoniae had a measured MAR index greater than 0.2, with confirmatory high rates of resistance to aminopenicillins and cephalosporins. Alarmingly high MARI values were measured in all representatives of Enterococcus faecalis, Enterobacter species and Pseudomonas aeruginosa. These strains were also established to have high levels of resistance (varying from 58.3 to 100 %) to some of antimicrobial medicines most commonly prescribed in the outpatient healthcare. Findings of this study emphasize the importance and seriousness of the existing problem with the increasing prevalence of uropathogenic microorganisms with multiple resistance to oral antibiotics. This creates elevated risks of failure to provide effective treatment for patients.

Prevalence and antimicrobial susceptibility characterization of Escherichia coli isolated from the intestines of freshwater fish from the Mindu dam in Morogoro, Tanzania

Background: The Mindu dam, an open system, serves as a microbial reservoir, housing uropathogenic microorganisms like Escherichia coli. Morogoro municipality relies on the dam for water and fish. This study aimed to assess the antimicrobial susceptibility of Escherichia coli isolated from fish and water in Mindu dam. Methods: In May 2019, a cross-sectional study was conducted in Morogoro municipality. Selected antimicrobials, including ampicillin, tetracycline, cefoxitin, erythromycin, trimethoprim, gentamicin, enrofloxacin, and nalidixic acid, were tested using the disc diffusion method. E. coli ATCC 25922 served as a positive control for quality assurance during bacterial isolation. The potential source of antimicrobial contamination was identified through the multiple antibiotic resistance index. Results: Out of 148 samples, E. coli was found in 24, none in water. E. coli showed high resistance (≥50.0%) to erythromycin (62.5%), nalidixic acid (79.2%), and ampicillin (75%). Additionally, 58.0% of isolates displayed multi-drug resistance across antimicrobial classes, with a multiple antibiotic resistance index ranging from 0.00 to 0.75. Conclusion: Antimicrobial-resistant E. coli in the food chain may heighten the spread of complex urinary tract infections in the municipality. It underscores the necessity for robust municipal surveillance of antimicrobial resistance and effective antimicrobial stewardship for enhanced infection prevention and control.

Evaluation of antibacterial, antifungal and antibiofilm activities of A. baumannii-derived tannase and gallic acid against uropathogenic microorganisms

One of the most prevalent infectious diseases and a key driver of antibiotic prescriptions in pediatrics is urinary tract infection (UTI). Due to the emergence of more resistant uropathogenic bacterial and fungal strains, current treatments are no longer effective, necessitating the urgent development of novel antibacterial and antifungal drugs. In this study, the antifungal, antibacterial, and anti-biofilm capabilities of compounds, such as tannase (TN) and gallic acid (GA), which were produced from a novel natural source, Acinetobacter baumannii (AB11) bacteria, were assessed for the inactivation of uropathogenic microorganisms (UMs). Ammonium sulphate precipitation, ion exchange, high-performance liquid chromatography, and gel filtration were used to purify TN and GA that were isolated from A. baumannii. A 43.08 % pure TN with 1221.2 U/mg specific activity and 10.51 mg/mL GA was obtained. The antibacterial, antifungal and anti-biofilm activities of TN and GA were evaluated against UMs and compared to those of commercially available antibiotics including sulfamethoxazole (SXT), levofloxacin (LEV), ciprofloxacin (CIP), amikacin (Ak), and nitrofurantoin (F). The results showed that TN and GA were superior to commercial antibiotics in their ability to inactivate UMs and considerably reduced biofilms formation. Additionally, the GA emerges as the top substitute for currently available medications, demonstrating superior antibacterial and antibiofilm properties against all UMs evaluated in this study. The results of this investigation showed that A. baumannii-derived TN and GA could be utilized as an alternative medication to treat UTIs.

Microbial Transfer by Intermittent Catheters: An In Vitro Evaluation of Microbial Transfer in Catheter With Variable Protective Features.

The purpose of this study was to evaluate the effects of various protective features (eg, catheter cap, introducer tip, and catheter sleeve) of hydrophilic intermittent catheters against contamination with urinary tract infection-associated microorganisms using an in vitro model. An in vitro study of microbial transfer. Gloves were contaminated with uropathogenic microorganisms and used to simulate intermittent catheterization of male anatomical models with and without the protective features present in 5 commercially available hydrophilic catheters. Using this contaminated touch transfer method, both the meatus of the sterile male anatomical models and sterile surgical gloves of an operator were inoculated with a high level of microorganisms (107 and 109 colony-forming units [CFU], respectively). The operator then performed catheterization of the anatomical model. The most relevant segments of the catheter were sampled, and the level of microbial transfer and catheter contamination was quantified. Results from experimental and sample replicates from the 3 microbial species and 5 catheters (sleeved and unsleeved) were analyzed by pair-wise t tests and analysis of variance. Of the 5 commercially available sleeved intermittent catheters evaluated in this study, use of catheters with multiple protective components (ring cap, introducer tip, and catheter sleeve) resulted in significant improvement in protection against contamination with a 25- to 2500-fold lower level of microbial contamination (C1 segment) across all species as compared to catheters protected with only sleeves or un-sleeved catheters. The combination of a ring cap, protective introducer tip, and protective sleeve provides additional protection when compared to sleeve alone from transferring microbial contamination from the meatus to the advancing catheter. Additional research is needed to determine whether these design features result in fewer urinary tract infections among intermittent catheter users.

Identification and antibiogram of Enterobacterales from direct urine samples using matrix assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF-MS) technology and disk-plate diffusion technique

Identification and antibiogram of uropathogenic microorganisms from direct urine samples present a great clinical impact. Here, we present a combined procedure to determine identification (IDd) of bacteria through MALDI-TOF-MS technology and antibiogram (ATBd) using disk-plate diffusion technique, of UTI-producing Enterobacterales against the most used antibiotics. Ninety-four urine samples with presence of pyuria and Gram-negative bacilli were selected. The IDd showed a high success rate (90%). ATBd procedure showed a high correlation for tested antibiotics. This simplified, low cost and reduced work time two-step procedure significantly reduces results turnaround time and benefit the clinical management of patients with UTI.

Effect of pH, Norepinephrine and Glucose on Metabolic and Biofilm Activity of Uropathogenic Microorganisms.

Urinary tract infection (UTIs) aremainly caused by a number of anatomical and physiological dysfunctions, but there are also some iatrogenic factors, including the use of certain medications, that contribute to the development of UTIs. The virulence of bacteria that colonize the urinary tract may be modified by pH and by the presence of soluble substances in urine, such as norepinephrine (NE) and glucose. In this work, we studied the influence of NE and glucose across a range of pHs (5, 7, 8) on the biomass, matrix production and metabolism of uropathogenic strains of Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Enterococcus faecalis. We used Congo red and gentian violet to stain the extracellular matrix and biomass, respectively, of biofilms. The optical density of staining of the biofilms was measured using a multichannel spectrophotometer. The metabolic activity was analyzed by MTT assay. It was shown that NE and glucose stimulate biomass production both in the Gram-negative and Gram-positive uropathogens. The metabolic activity in the presence of glucose was higher at pH 5 for E. coli (in 4.0 ± 0.1 times), Ps. aeruginosa (in 8.2 ± 0.2 times) and Kl. pneumoniae (in 4.1 ± 0.2 times). Matrix production of Kl. pneumoniae increased under NE (in 8.2 ± 0.2 times) and in the presence of glucose (in 1.5 ± 0.3 times). Thus, NE and glucose in urine may lead to persistent UTI under patient stress and in the case of metabolic glucose disorders.

Enhancement of the Efficacy of Photodynamic Therapy against Uropathogenic Gram-Negative Bacteria Species

Antimicrobial photodynamic therapy (aPDT) was demonstrated to be effective against various species of Gram-positive bacteria. However, the complex structure of a Gram-negative bacteria envelope limits the application of aPDT. Thus, the goal of this study was to improve the efficiency of antimicrobial photodynamic therapy with Fotoditazin against uropathogenic Gram-negative bacteria. The non-ionic detergent Triton X-100 and emulsifier Tween 80 were tested. The effect of extracellular photosensitizer on aPDT efficacy was analyzed. Moreover, the irradiation regime was optimized in terms of the output power and emitting mode. It was found that Triton X-100 at 10% vol enhanced the efficacy of aPDT of E. coli up to 52%. The subsequent observation demonstrated that, when the photosensitizer was removed from the extracellular space, the efficacy of aPDT on various Gram-negative species decreased dramatically. As for the irradiation mode, an increase in the laser output power led to an increase in the aPDT efficacy. The pulsed irradiation mode did not affect the aPDT efficacy. Thus, in order to achieve optimal aPDT efficacy, bacteria should be irradiated at 450-mW output power in the presence of Triton X-100 and a photosensitizer in the extracellular environment. However, it should be noted that the efficacy of aPDT of K. pneumoniae was significantly lower than for other species. The developed aPDT technique may be effective in a native environment of uropathogenic microorganisms.

Assessment of Bacterial Isolates from the Urine Specimens of Urinary Tract Infected Patient.

Urinary tract infections (UTIs) maintained a serious public health concern, as did the growth in antibiotic resistance both between uropathogenic microorganisms. A regular assessment of the microbiological agents that cause UTIs, as well as their antimicrobial resistance, is essential for a tailored empirical antibiotic response. Knowing the variables that cause UTIs can help you intervene quickly and simply to get the condition under control. The most common infecting species in acute infection is Escherichia coli (E. coli). To strengthen infection control strategies, it is necessary to know the prevalence and location of UTI. The goal of this research is to measure the frequency of microorganisms isolated from patients with UTIs as well as the antimicrobial sensitivity characteristics of Gram-negative bacteria. The purpose of this research has been to evaluate the frequency of UTIs by extracting and characterizing the various bacterial etiological organisms, as well as to assess the factors linked to UTIs. The goal of this research is to identify, characterize, and establish the antibiotic susceptibility patterns of bacteria linked to urinary tract infections. Fresh collected urine specimen was taken from inpatients or outpatients in UTI cases and bacteriologically tested using conventional microbiological methods. The Kirby-Bauer disc diffusion method was used to create the antibiogram. Staphylococcus saprophyticus, Staphylococcus aureus (28%), and Escherichia coli (24.6%) were the most common isolates (20%). The evaluated agents' antibacterial activity was all in the following order: cefixime, ciprofloxacin, augmentin, gentamicin, ceftazidime, nitrofurantoin, ofloxacin, and cefuroxime. It was discovered that each and every one of the microbes exhibited varied degrees of resistance to the antibiotics nitrofurantoin, ciprofloxacin, and ofloxacin. Every type of bacteria, with the exception of those belonging to the genus Streptococcus, has a Multiple Antibiotic Resistance Index (MARI) that is more than 0.2. The first-line therapies for urinary tract infections (UTIs) in the region would consist of ciprofloxacin, ofloxacin, and nitrofurantoin. Lower urinary tract infections almost never result in problems if they are diagnosed and treated as soon as possible and in the correct manner. However, if treatment is not sought, a urinary tract infection can lead to serious complications.

Bacteriological profile of urinary tract infections and antibiotic susceptibility of Escherichia coli in Algeria.

Background and Objectives:Urinary tract infections are one of the most common bacterial infections worldwide. The emergence of antibiotic-resistant bacterial strains is a serious problem and greatest challenge in public health care. The purpose of this study was to determine the prevalence of uropathogenic microorganisms and the antibiotic resistance pattern of Escherichia coli in Algeria.Materials and Methods:Urine samples were collected from 760 outpatients in the hospital of Tizi-Ouzou (Algeria). From the positive cultures, 120 strains of E. coli were isolated and tested for their susceptibility to antibiotics by disk diffusion method on Mueller Hinton agar medium.Results:Among the collected urine specimens, 270 (35.5%) yielded positive cultures for urinary tract infection. Females were more affected with a sex ratio F/M of 1.14. E. coli was the most prevalent isolated bacteria with a rate of 44.44%, followed by Klebsiella pneumoniae (12.21%), Pseudomonas aeruginosa (11.1%) and Proteus mirabilis (5.55%). Isolates of E. coli showed high level of resistance to cephalothin (85.83%), ticarcillin (82.5%), ampicillin (73.3%) and amoxicillin-clavulanic acid (58.33%). Imipenem was the most effective antimicrobial agent.Conclusion:These results highlight the inappropriate utilization of antibiotics and suggest the need to improve prescription practices in our country.

Application of photodynamic inactivation against pathogens of urinary tract infections

Photodynamic inactivation (PDI) is an alternative to antibiotic therapy method for biocidal action against microorganisms, which can be used for lithotripsy and sanitation of the bladder cavities. Objective. Selection of parameters and application PDI against uropathogenic microorganisms. Materials and Methods. In this study we used bacterial strains isolated from urine samples of patients. Differentiation media and biochemical plates were used for identification of microorganisms. The sensitivity of uropathogenic microorganisms to PDI was studied on pure cultures and in native urine. The photosensitizer “Photoditazine” (50 µg/ml) was used in the work, as well as Triton X-100 (5 % vol.) was applying to increase the permeability of the cell wall of gram-negative microorganisms. The samples were irradiated by a medical laser device “Latus-K” with a wavelength of 662 nm. To assess the effectiveness of PDI, the values of the logarithmic decrease of colony-forming unit (CFU) of the microorganisms were calculated. Statistical analysis was made by Statistica 10.0 and Mann-Whitney criterion. Results. 50 strains of uropathogens belonging to 18 species were isolated from 36 samples of native urine. Among them, the most common were S. aureus, E. coli, P. aeruginosa, K. pneumoniae. The value of logarithmic decrease in CFU for gram-positive bacteria ranged from 5 to 6, which corresponds to inactivation 99.999-99.9999% of bacterial cells in a sample. For gram-negative strains, this value was slightly lower and ranged from 4 to 5.5, which, nevertheless, corresponds to inactivation 99.99-99.999% of CFU bacteria. The addition of Triton X-100 increase the efficiency from 46% to 99.99% for E. coli, from 99% to 99.99% for P. mirabilis, from 16% to 94% for K. pneumoniae and from 97% to 99.999% for P. aeruginosa. It should be noted that the PDI was affect microorganisms both in isolated pure cultures and in native urine. Conclusions. Photodynamic inactivation may be considered as an alternative to antibiotic therapy method of biocidal action against uropathogenic microorganisms.

Efficacy of Photodynamic Inactivation against the Major Human Antibiotic-Resistant Uropathogens

Photodynamic inactivation (PDI) is considered to be an effective method of prevention of postoperative complications of urolithiasis. The present study shows a complex approach to assess the efficacy of PDI of drug resistant bacteria associated with renal calculi. Bacterial strains associated with renal calculi were isolated and identified using standard methods of bacteriological analysis and tested for drug resistance to 10 antibiotics by the disco-diffusion method. Uropathogenic bacterial strains present in 78.7 ± 5.2% of the infected samples from the total number of analyzed calculi. The most frequent representatives belonged to the genera Staphylococcus, Escherichia, and Enterococcus. All tested strains showed high antibiotic resistance. Representatives of the most common bacterial genera in the calculi were used as models for the selection of PD exposure modes. It was found that the maximum time of photosensitizer accumulation depends on the structure of the bacterial cell wall: 30 min for Gram-negative strains and 60 min for Gram-positive ones. Optimal modes of PD exposure to antibiotic-resistant uropathogenic microorganisms were selected: 50 µg/mL Fotoditazin and 150 mW laser power. The maximal bactericidal activity of PDI against uropathogenic microorganisms was shown for Enterococcus faecalis, and Staphylococcus aureus. The bacteriostatic effect was found against Escherichia coli and Proteus mirabilis.

Patterns of Extended-Spectrum β-Lactamase Producing Uropathogens Detection in Tertiary Care Hospital of Bangladesh

It is a great concern that extended-spectrum β-lactamase (ESBL) and non-ESBL uropathogenic micro-organisms have been worldwide illustrated to increase multidrug resistance. To study the prevalence and patterns of uropathogens, and antimicrobial susceptibilities profiles of ESBL and non-ESBL producing bacterial infection in a tertiary level health service center of Bangladesh. The prevalence of ESBL producing uropathogens and their antimicrobial resistance patterns were identified in 176 isolates from patients with UTI. ESBL and non-ESBL producing bacterial isolates and their antibiotic sensitivity and resistance patterns were distinguished from the 176 patients of suspected urinary tract infection. The Double-disc diffusion test was done to determine the presence of ESBL-producing bacterial strains. The most widely ESBL positive uropathogen was Escherichia coli (87%), followed by Pseudomonas aeruginosa, (6.8%), Enterococcus spp. (3.4%), Acinetobacter spp. (2.5%) and non-ESBL positive E. coli (41.4), Staphylococcus saprophyticus (25.9%), Pseudomonas aeruginosa (17.2%), Staphylococcus aureus (10.3%), and Klebsiella pneumoniae (5.2%). The current investigation found most frequently Escherichia coli in both ESBL and non-ESBL uropathogenic groups as 87% and 41.4% respectively. Generally, a large number of antibiotic resistance patterns and ESBL producing common bacterial isolates were found in this study which increases the public health problem. Therefore, for safe human life, we ought to be taking appropriate action against the threat.

Urinary tract infections: Virulence factors, resistance to antibiotics, and management of uropathogenic bacteria with medicinal plants—A review

Urinary tract infections (UTIs) are among the most common infections in most countries and they are usually caused by the so-called uropathogenic (UP) microorganisms, including Escherichia coli (80%–90%), Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, Proteus mirabilis, and Klebsiella pneumoniae. Over the years, the growth of resistance to antibiotics has complicated the treatment of UTIs and has direct consequences on the cost of treatment, the severity of infections, and the length of hospitalization. Medicinal plants, used for thousands of years to treat various diseases, constitute a serious alternative to antibiotics in the public health issue of antimicrobial resistance. In this review, the in vitro and in vivo use of medicinal plants and their nanoparticles (silver, gold, zinc, copper oxide, magnesium oxide, iron, etc.) in the management of uropathogens and their virulence factors (VFs) as well as in the management of UTIs themselves have been discussed. Given the advantages offered by the biologically active compounds of medicinal plants as well as their green-synthetized nanoparticles whether used as such or in combination with conventional antibiotics, it can be concluded that herbal medicine can significantly help in the management of UTIs.

Phage Therapy as a Novel Strategy in the Treatment of Urinary Tract Infections Caused by E. Coli.

Urinary tract infections (UTIs) are regarded as one of the most common bacterial infections affecting millions of people, in all age groups, annually in the world. The major causative agent of complicated and uncomplicated UTIs are uropathogenic E. coli strains (UPECs). Huge problems with infections of this type are their chronicity and periodic recurrences. Other disadvantages that are associated with UTIs are accompanying complications and high costs of health care, systematically increasing resistance of uropathogens to routinely used antibiotics, as well as biofilm formation by them. This creates the need to develop new approaches for the prevention and treatment of UTIs, among which phage therapy has a dominant potential to eliminate uropathogens within urinary tract. Due to the growing interest in such therapy in the last decade, the bacteriophages (natural, genetically modified, engineered, or combined with antibiotics or disinfectants) represent an innovative antimicrobial alternative and a strategy for managing the resistance of uropathogenic microorganisms and controlling UTIs.

Pre-Use Ureteroscope Contamination after High Level Disinfection: Reprocessing Effectiveness and the Relation with Cumulative Ureteroscope Use.

We assessed the frequency of preoperative and persistent microbial contamination of flexible ureteroscopes after reprocessing and the relation of contamination to cumulative ureteroscope use. We evaluated the effectiveness of high level disinfection with peracetic acid as well as data on ureteroscope use for 20 new flexible ureteroscopes from December 2015 to December 2017 at a single center. In the operating room pre-use and postuse microbial samples of the ureteroscope shaft and working channel were collected to evaluate microbial contamination after reprocessing. Positive cultures were defined as 30 cfu/ml or greater of skin flora, or 10 cfu/ml or greater of uropathogenic microorganisms. A generalized estimating equation model was used to analyze whether cumulative ureteroscope use was associated with positive pre-use cultures. Microbial samples were collected during 389 procedures. Pre-use ureteroscope cultures were positive in 47 of 389 procedures (12.1%), of which uropathogens were found in 9 of 389 (2.3%) and skin flora in 38 of 389 (9.8%). Urinary tract infection symptoms did not develop in any of the patients who underwent surgery with a uropathogen contaminated ureteroscope. In 1 case the pre-use culture contained the same bacteria type as the prior postuse culture. Cumulative ureteroscope use was not associated with a higher probability of positive cultures. Microbial contamination of reprocessed ureteroscopes was found in an eighth of all procedures. Notably uropathogenic microorganisms were discovered in a small proportion of all procedures. Persistent ureteroscope contamination with uropathogens was only rarely encountered. Cumulative ureteroscope use was not associated with a higher probability of microbial contamination.

Alterations in human sperm parameters as a corollary of incubation with various uropathogenic microorganisms

Purpose: To analyze the impact of different uropathogenic microorganisms on various sperm parameters those are generally used to determine male fertilizing potential. Method: The standard strains viz. Serratia marcescens, Klebsiella pneumoniae, Enterobacter aerogenes, Candida albicans, Proteus mirabilis, Streptococcus pyogenes, Klebsiella oxytoca were checked for their impact on sperm motility, viability, morphology, Mg++ ATPase activity and acrosome status of spermatozoa. Results: S. marcescens, K. pneumoniae, E. aerogenes compromised sperm motility via agglutination and C. albicans impaired motility without agglutination. Further, these strains could also reduce viability resulting in sperm death. These strains induced morphological defects in spermatozoa as evident by electron microscopic studies. Incubation of spermatozoa with these uropathogenic strains led to reduction in Mg2+ dependent ATPase activity and also resulted in premature acrosomal loss. On the other hand, P. mirabilis, S. pyogenes, K. oxytoca did not alter any of these parameters. Conclusion: It can be concluded from the present study that certain uropathogenic strains can induce detrimental effects on spermatozoon thereby reducing its fertilizing ability.

Alterations in human sperm parameters as a corollary of incubation with various uropathogenic microorganisms

Alterations in human sperm parameters as a corollary of incubation with various uropathogenic microorganisms

English

The objective of this study was to review the antimicrobial susceptibility patterns of uropathogenic microorganisms associated with VVF patients in Abakaliki, South eastern Nigeria. Out of the 117 bacterial isolates obtained from 108 mid-stream urine samples of VVF patients, 72 isolates [15 (20.8%) Staphylococcus aureus, 8 (11.1%) Enterococcus faecalis, 12 (16.7%) Klebsiella pneumoniae, 11 (15.3%) Proteus mirabilis, and 26 (36.1%) Escherichia coli] were obtained from pre-surgery VVF patients, while 45 isolates [7 (15.6%) Staphylococcus aureus, 3 (6.7%) Enterococcus faecalis, 4 (8.9%) Klebsiella pneumoniae, 15 (33.3%) Proteus mirabilis, and 16 (35.6%) Escherichia coli] were obtained from post-surgery VVF patients. The bacterial isolates exhibited resistance (57.1 to 75%) to co-trimoxazole, tetracycline, amoxicillin, ceftazidime, and nitrofurantoin. Antibiogram also revealed that imipenem was the most active antibiotic against the bacterial isolates as 80 to 100% of the bacterial isolates were susceptible to this antibiotic. Our findings affirmed that VVF patients are prone to microbial colonization and these microbes showed varying degrees of susceptibility to different classes of antibiotics. Therefore, there is urgent need for constant monitoring and evaluation of antibiotics used in the treatment of uropathogenic infections in VVF patients to avoid full-blown antibiotic resistance menace which might eventually result in serious public health problem. Key words: Antimicrobial susceptibility, uropathogenic microorganisms, vesico-vaginal fistula (VVF).

The investigation of the cranberry (Vaccinium oxycoccos L.) concentrated juice antimicrobial activity

The urinary system infections is one of the most common diseases of the genitourinary system in women. Of particular interest in the prevention and treatment of chronic cystitis is the consumption of the cranberry (Vaccinium oxycoccos L.) fruits. This plant has long been used in urological practice due to the content of proantocianidins, flavonoids, organic acids (benzoic, citric, quinic, ursolic), pectin substances, vitamins, microelements etc. Numerous clinical studies (including randomized, double-blind, placebo-controlled) reveal statistically reliable efficiency of cranberry juice in the forms of concentrates, cocktails and capsules to urinary system infections prevention in women.
 Since the main pathogens of urinary system infections are Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, the aim of our work was to study the antimicrobial properties of the cranberry concentrated juice.
 Comparative testing of antimicrobial activity was performed using micromethod of diffusion in agar.
 The carried out study indicates that the concentrated juice maintains antimicrobial properties to the most common uropathogenic microorganisms. Effective antimicrobial concentration was found according with analysis of microbial cultures growth curves in a nutrient medium with various juice dilutions. Gram-positive bacteria (S. aureus, E. faecalis) are more sensitive to the cranberry concentrated juice than gram-negative (E. coli and P. aeruginosa).
 The adhere ability to a solid surface with the subsequent formation of biofilm is an important factor in the uropathogenic bacteria virulence. Therefore, the next step was to study the effect of cranberry juice biologically active compounds on the biofilms formation in the uropathogenic bacteria broth cultures. It was determined that cranberry juice suppresses the biofilm formation of S. aureus with the greatest intensity. It was observed the 45,3–55,8% reduction of the biofilm creating intensity in the presence of the condensed juice subbacteriostatic dilutions. When the condensed juice was diluted as 1:160, inhibition of E. faecalis biofilm formation ability on 44,90% was detected. The effect of cranberry biologically active compounds on the biofilms formation by gram-negative bacteria was observed in the range of 20%.
 Thus, the obtained cranberry concentrated juice can be recommended as the remedy for application in prevention of recurrent urinary system infections.