Uropathogens In Urinary Tract Infections Research Articles

P20 Rapid 15 min test to identify the three most common Gram-negative uropathogens in urinary tract infections

Abstract Background Every year, 6.2 million cases of urinary tract infection (UTI) are reported in England and Wales and have the second highest antibiotic prescription rate. The absence of fast and sensitive diagnostic tests has increased empirical antibiotic use and has contributed to the rise of antibiotic-resistant infections. To address this challenge, we have developed NANOPLEX™: a rapid 15 min test that uses glycan-functionalized-latex nanoparticles, microscopy and image-analysis software to identify and enumerate samples with bacteria. In this work, we show that NANOPLEX™ can correctly identify the three most common uropathogens using lab reference strains, clinical isolates and clinical urine samples. Materials and Methods The NANOPLEX™ assay was performed as per Vendeville et al. 2021.1 ACS Biomater 2022; 8, 1:242-252. Clinical isolates of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were obtained from an NHS clinical microbiology lab waste stream. N=30 isolates (per species) were tested via single-blind study protocols at concentrations of 10³–108 cfu/mL and compared with microbial culture to define performance metrics (sensitivity, specificity, PPV, NPV and accuracy) of each probe. Results A total of 90 isolates were tested against their target probes and demonstrated >90% accuracy (sensitivity 88%–90%, specificity 94%–98%, PPV 93%–98%, NPV 88%–90%, accuracy 91%–94%) for all probe-bacteria combinations at clinically significant concentrations (105 cfu/mL). Conclusions NANOPLEX™ was able to successfully detect the top three common Gram-negative pathogens in UTI at clinically relevant concentrations. A compact hardware and single-use cartridge system is under development to enable urologists to conduct rapid and accurate UTI testing in point-of-care environments. Larger clinical studies are planned to clinically validate these results.

Antimicrobial susceptibility pattern of uropathogens in urinary tract infections (UTI) patients of Punjab, Pakistan

The prevalence, antimicrobial susceptibility pattern, and associated factors of urinary tract infections among Punjabi patients attending Tertiary Care Hospitals of Punjab were the objectives of this study. Participants were selected by systematic random sampling in a cross-sectional study at Tertiary Care Hospitals of Punjab. 988 participants provided clean catch midstream urine samples, which were then cultured and tested for antimicrobial susceptibility. We inoculated n=988 urine samples in which 255 samples were found positive for bacterial growth. Among them 126 were E. coli, 66 Klebsiella pneumoniae, 4 Enterobacter cloacae, and 21 were Pseudomonas spp. The frequency of Uropathogens was observed for Gram negative E. coli 49.02% and Gram positive bacteria were 7.78%. The prevalence of urinary tract infections was 16.4%. Pseudomonas aeruginosa (19, 7.3%), Pseudomonas spp. (2, 0.7%), Enterobacter cloacae (4, 1.5%), and Gram positive bacteria such as Methicillin resistant staphylococcus aureus (3, 1.1%), Methicillin sensitive staphylococcus aureus (15, 5.8%), and Enterococcus faecalis (20, 7.7%) were the most common bacteria. Ampicillin and tetracycline were both resistant to Gram-negative bacilli (96%) and Gram-positive cocci (72%), respectively. In the study area, a culture and susceptibility test is essential for effective urinary tract infection management.

Current Antibiotic Resistance Pattern of Prevalent Uropathogens in Urinary Tract Infection of Diabetic Patients in Comparison with non-Diabetics

Introduction: Urinary tract infections (UTIs) are a common infectious disease worldwide. Bacterial resistance to antibiotics is one of the most challenging global health problems. Regional surveillance programs are necessary to update knowledge on antimicrobial resistance patterns for empirical antibiotic treatment of the patients. This study aimed to explore the bacteriology and antibiotic resistance pattern of urological pathogens in diabetic patients compared to that in non-diabetics. Materials and Methods: A prospective study during the period from June 2021 to November 2021 in Khulna City Medical College Hospital was carried out including 347 diabetic and non-diabetic patients. Midstream clean-catch urine samples were collected from suspected UTI patients of age more than 14 years and inoculated in Mac Conkey & Blood agar media for semi-quantitative urine culture and sensitivity test. Antibiotic susceptibility test was done by Kirby-Bauer disc diffusion method following clinical laboratory science (CLS) program. Results: Among the 347 inoculated samples, Culture positive were in 286 cases. Gram-negative E. coli was isolated from 119 (overall 41.6%, 51% in diabetics and 36.5% in non-diabetic patients) samples which were the most predominant bacteria, followed by Enterococcus, Pseudomonas and Klebsiella. UTI with E. coli was significantly at a higher rate in diabetic patients and Exhibits 100% resistance to Ceftriaxone, Nalidixic acid, Cefuroxime and Cefixime. Bacteria offered a high degree of resistance against commonly used antibiotics-Amoxycillin, Ciprofloxacin, Amikacin, Gentamycin, Levofloxacin, Nalidixic acid and Nitrofurantoin ranging from 7% to 93%. Conclusion: E. coli infection is significantly predominant in UTI cases in this study and exhibits a higher rate of resistance to all antibiotics in diabetic patients than that in non-diabetics. None of the antibiotics is 100% sensitive in diabetic patients. Imipenem, meropenem and Piperacillin remain .......

A Cross-Sectional Study to Evaluate Antimicrobial Susceptibility of Uropathogens from South Punjab, Pakistan.

BackgroundUrinary tract infections (UTIs) are a common infection caused by uropathogenic bacteria. Drug resistance against common antibiotics is a leading cause of treatment failure in UTIs.ObjectiveThis study was conducted to check the prevalence of antimicrobial susceptibility against uropathogens and identify the best treatment option against UTIs.MethodsIn this cross-sectional study, urine samples (n = 1000) were collected and cultured for pure bacterial growth by using cysteine–lactose–electrolyte-deficient (CLED) media. After physical and biochemical characterization, antibacterial susceptibility was performed by the Kirby–Bauer disk diffusion method.ResultsUropathogenic bacteria were successfully isolated in 57% (n = 572) of total tested samples (n = 1000). Escherichia coli 51.2% (n = 293/572), Klebsiella species 15.4% (n = 88/572), Enterococcus species 15.4% (n = 88/572), Pseudomonas species 9.4% (n = 54/572), Staphylococcus aureus 3.2% (n = 18/572), coagulase-negative Staphylococci (CoNS) 3.0% (n = 17/572) and Proteus species 2.4% (n = 14/572) were the most prevalent organism in UTIs. Prevalence of Gram-negative rods (GNRs) was 78.5% (n = 449/572) among UTI patients as compared to Gram-positive cocci (GPCs) 21.5% (n = 123/572). Escherichia coli 65.3% (n = 293/449), Klebsiella species 19.6% (n = 88/449), Pseudomonas species 12.0% (54/449) and Proteus species 3.1% (n = 14/449) were the most prevalent GNRs in UTIs, while Enterococcus species 71.5% (n = 88/123), Staphylococcus aureus 14.6% (n = 18/123) and coagulase-negative Staphylococci (CoNS) 13.8% (17/123) were the most prevalent GPCs in UTIs. The majority of isolated uropathogens showed resistance against routinely used antibiotics. However, teicoplanin and linezolid were the most effective drugs against GPCs and piperacillin/tazobactam, meropenem and imipenem were the most effective drugs against GNRs. Nitrofurantoin and fosfomycin were shown to be most effective against both GNRs and GPCs.ConclusionIn conclusion, Escherichia coli (GNRs) and Enterococcus species (GPCs) are the most prevalent organisms among UTIs patients, which are shown to be antibiotic-resistant to the most commonly used antibiotics. However, nitrofurantoin and fosfomycin are the most effective drugs against uropathogens in UTIs.

Prevalence of urinary tract infections and current scenario of antibiotic susceptibility pattern of bacteria causing UTI

Introduction: Urinary tract infection (UTI) is one of the most prevalent diseases affecting people of all age groups i.e. from neonate to geriatric age group. Widespread use of antibiotics has led to the emergence of resistant microorganisms. As the antibiogram of the microorganisms are frequently changing hence the present study was done to analyze the recent antibiotic sensitivity pattern of uropathogens in urinary tract infection. Materials and Methods: In present study is a retrospective analysis of culture results of urine samples, was conducted at Microbiology department of tertiary health care hospital in Mumbai. The age & sex of patients, the organism isolated and also the antimicrobial susceptibility profiles were collected from the laboratory registers using a standard data collection form. Results: The overall prevalence of UTI was 33.54% of which 66.78% were females and 33.22% were from males. High prevalence was observed in females as compared to males (2:1). Though the overall prevalence was high in old aged (>45 years) patients, in females high prevalence was seen among middle-aged (31 to 45 years) patients and in male high prevalence was seen among old age (>45 years) patients. From total 584 uropathogens, E.coli (53.77%) was the commonest isolate causing UTI followed by Klebsiella pneumoniae (27.40%). The most effective antimicrobial agents in our study were Meropenem, gentamicin, Nitrofurantoin and Cotrimoxazole whereas higher resistance was observed among Fluoroquinolones, Amoxicillin and third generation Cephalosporins, these are the drugs which are commonly given emperically for UTI. Conclusion: As drug resistance among bacterial pathogens is vary with time to time regular surveillance and monitoring is necessary for giving updated information to physician for most effective empirical treatment of UTIs. Keywords: Urinary tract infection, Prevalence, Antibiotics resistance, Uropathogenes.

Multidrug Resistant Uropathogens among Egyptian Pregnant Women

Urinary Tract Infections (UTIs) in pregnancy is a common medical problem associated with significant increase in the risk of fetal morbidity and mortality. The effective appropriate antimicrobial agent is a major concern as many effective antimicrobial groups cannot be used due to their potential toxicity to the fetus as well as the increasing rates of Multidrug-Resistant (MDR) strain isolation. This cross- sectional study was conducted on women attending the antenatal care of Zagazig University. This study aimed to estimate prevalence of various uropathogens in UTI among the pregnant women and determine their antimicrobial resistance patterns. Clean catch mid-stream urine samples were obtained, complete microbiological examination and antibiotic susceptibility testing were carried out. More than half of culture positive samples was obtained from asymptomatic pregnant women. Asymptomatic bacteriuria was more common among primigravida, women of low socioeconomic class and with history of previous Cesarean section. Gram negative bacterial isolates were the most prevalent (71%). The most frequently isolated pathogens were: E. coli 34%, K. pneumoniae 26% and S. saprophyticus 23%, among the total Gram negative isolates, 95.0% were MDR. Meropenem was the antibiotic with the highest susceptibility rate (96%) on E coli isolates, followed by nitrofurantoin (74%) and tobramycin (72%). Recommendations: Urine culture and sensitivity must be the role as MDR pathogens are increasing, rationalization of antibiotic administration is a must.

Antibiotic resistance pattern of uropathogens in urinary tract infections in children at State Referral Hospital, Falkawn, Mizoram, India

Background: Analysing antibiotic susceptibility pattern of uropathogens help to overcome the therapeutic difficulties created by the rising anti-microbial resistant bacteria and guides in choosing appropriate antibiotics. Hence, we aimed at evaluating the uropathogens causing urinary tract infections and study their antibiograms.Methods: Midstream urine samples were collected, cultured and appropriate biochemical tests were performed for proper identification of urinary tract pathogens in State Referral Hospital Falkawn, Mizoram, India from 1st January to 30th June 2018.Results: The most common isolated gram-negative uropathogens were Escherichia coli (40.9%), followed by Klebsiella spp. (17.6%), Proteus spp. (10.7%) and Pseudomonas spp. (3.1%). Among gram-positive organisms Enterococcus spp. (20.1%) and Staphylococcus spp. (7.6%) were grown. Urinary tract infections were more prevalent in girls (64.8%) than boys (35.2%). High level of resistance was found to amoxycillin/ampicillin by all the organisms isolated.Conclusions: Almost all the test organisms exhibited multiple antibiotic resistance. The study identified multiple antibiotics resistance by uropathogens which were earlier used as first line of treatment of UTI in children.

THE CURRENT STATE OF ANTIBIOTIC RESISTANCE AND THE COMPOSITION OF PATHOGENS OF URINARY TRACT INFECTIONS IN PREGNANT WOMEN

Introduction.The main treatment component of asymptomatic bacteriuria, acute cystitis and pyelonephritis in pregnant women is antibiotic therapy, which in many patients is prescribed empirically. For successful selection of the drug, it is necessary to know both the structure of pathogens and the current profile of their antibiotic resistance.Purpose of research.The study of species composition and resistance to antibiotics of bacteria that cause urinary tract infections (UTIs) in pregnant women in the Moscow RegionMaterials and methods.The study included 104 pregnant women with uncomplicated UTIs who were observed and treated at the Lapino Clinical Hospital between 2016 and 2017. The material for bacteriological studies was the midstream portion of urine or urine collected by a catheter.Results.90 patients had asymptomatic bacteriuria, 10 had acute cystitis, and 4 had acute gestational pyelonephritis. The structure of the pathogens of UTI is presented: E. coli, Enterococcus faecalis, Klebsiella pneumoniae, Proteus spp., Staphylococcus spp., Streptococcus spp., Enterobacter cloacae. The most frequently detected pathogens were E. coli (67.3%) and E. faecalis (50%). Resistance rate of E.coli strains more than 20% was detected to ampicillin (36.4%), amoxicillin / clavulanate (23.2%), trimethoprim / sulfamethoxazole (27.4%), nalidixic acid (20.7%), cephalosporins 2 and 3 generation (respectively, 25.7% and 24.3%). Resistance rate more than 20% in Enterobacteriaceae family strains was detected to trimethoprim/sulfamethoxazole (24.4%), nalidixic acid (20.7%), cephalosporins 2 generations (21.7%). Antibiotic resistance of E.coli and other Enterobacteriaceae family taxons less than 10% was noted only with respect to carbapenems (0%) and fosfomycin (1.5% and 3.5%, respectively).Conclusions.It is expedient to use the obtained data on the composition and sensitivity profile of uropathogens in UTIs in pregnant women when choosing starting empirical antibiotic therapy. Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.

Bacterial Uropathogens in Urinary Tract Infection and Antibiotic Susceptibility Pattern in Riyadh Hospital, Saudi Arabia

Background: Urinary tract infection (UTI) is one of the commonest infections encountered by clinicians and despite the widespread availability of antimicrobial agents. UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents. The aim and objectives of this study were to determine the etiological Bacterial pathogens of the UTI and to determine the antibiotic sensitivity pattern of pathogens isolated. Results: The present study was carried out from the Central Laboratory of Riyadh Hospital in Saudi Arabia from January 2015 to Jun 2015.Total 116 urine samples were tested bacteriologically and for antibiotic susceptibility using standard procedures. This study describes the relationships between sex, isolated bacterial agents and antibiotic resistance of UTIs. Out of 116 samples of out patients, urinary tract infection (UTI), of these 70(60.35%) belonged to female and 46(39.66%) samples belonged to male patients, while adult patients included (22.41%) of female as well as male patients with the same percentage. It was found that old adult women have a higher prevalence of UTI than men. Escherichia coli was the most common isolate (78.45%) followed by Klebsiella pneumoniae (21.56 %) amongst the gram-negative bacilli. Also, the results showed that, E. coli occurred more frequently in women (50%) than in men (28.45%). All isolates of E. coli and K. pneumoniae were high susceptible to Meropenem, Imipenem, Colistin, Ertapenem and Amikacin. Conclusions: This study showed that E. coli isolates were the predominant pathogens and showed increasing resistance pattern to the commonly prescribed drugs in private practice that in turn leaves the clinicians with very few alternative options of drugs for the treatment of UTIs.

Serotyping and Antibiotic Susceptibility Pattern of Common Bacterial Uropathogens in Urinary Tract Infections in Koohdasht, Lorestan Province

Background: Oneof themostcommondiseases worldwide is urinary tract infection (UTI). The main agents causing these infectionsare bacteria. Urinary tract infections occur when uropathogens colonize the urethra, migrate to the bladder and invade urinary tract cells. Objectives: The purpose of this study was the detection of uropathogens causing UTIs, as well as serotyping and antibiotic susceptibility of the most common bacteria. Materials and Methods: The study was performed on 300 urine samples collected from patients referred to Koohdasht Imam Khomeini hospital of Lorestan province. After culturing the samples and determination of uropathogens, antibiotic susceptibility test was performed by the Kirby-Bauer disk diffusion method. Serotyping was performed for the most common uropathogens by polyvalent and monovalent antisera. Results: Of the 300 samples, 61 samples (20.33%) were positive for UTIs. Among these, 49 samples (80.33%) were Gram-negative bacteria and 12 (19.67%) Gram-positive. The most common uropathogens in UTIs were Escherichia coli (55.74%), Proteus species (11.47%), Staphylococcus epidermidis (11.47%), Citrobacter species (8.20%), Staphylococcus aureus (8.20%) and Klebsiella species (4.92%), respectively. The rate of UTI in females (83.61%) was more than males (16.39%). The highest level of resistance was towards trimethoprim/sulfamethoxazole and the lowest to ampicillin, ciprofloxacin and nitrofurantoin. The most common uropathogen was Escherichia coli and the most common serotypes were O142:K86 and O25:K11, respectively. Conclusions: The treatment of UTIs and resistance control in bacteria should be done based on common strains and choosing an effective antibiotic. Therefore, the determination of prevalent bacterial strains in UTIs of each region based on laboratory tests is very important.

Serotyping and Antibiotic Susceptibility Pattern of Common Bacterial Uropathogens in Urinary Tract Infections in Koohdasht, Lorestan Province

Serotyping and Antibiotic Susceptibility Pattern of Common Bacterial Uropathogens in Urinary Tract Infections in Koohdasht, Lorestan Province

Analysis of the spectrum and antibiotic resistance of uropathogens in vitro: Results based on a retrospective study from a tertiary hospital

Antibiotic resistance of uropathogens in urinary tract infections (UTIs) is increasing worldwide. This study aimed to compare the spectrum and antimicrobial resistance of uropathogens in community-acquired UTIs (CAUTIs) and nosocomial-acquired UTIs (NAUTIs) at a tertiary hospital in China. Retrospective analysis of uropathogens from UTI patients was performed at Zhong Da Hospital. A total of 1129 strains was isolated from 653 community-acquired and 476 nosocomial-acquired infections. Escherichia coli was the most common uropathogen, accounting for 55.9% of the CAUTIs and 27.1% of the NAUTIs. Among the CAUTIs, Escherichia coli was followed in prevalence by Enterococcus spp (12.9%) and Proteus mirabilis (3.7%). Among the NAUTIs, Escherichia coli was followed by Enterococcus spp (15.3%) and Klebsiella pneumoniae (6.9%). The proportion of fungi in the NAUTIs (23.7%) was higher than that in the CAUTIs (3.1%) (P < .05). Extended-spectrum β-lactamase-producing strains of E coli accounted for 70.6% of the NAUTIs and 47.3% of the CAUTIs. Carbapenems, amikacin, and nitrofurantoin were active agents against E coli. The resistance rates of E coli to cephalosporins, ampicillin, ampicillin/sulbactam, quinolones, and gentamicin were higher in the NAUTIs than in the CAUTIs (P < .05). The distribution of species was different between CAUTIs and NAUTIs. Higher antibiotic resistance rates were observed in the NAUTIs than in the CAUTIs.

Bacterial uropathogens in urinary tract infection and antibiotic susceptibility pattern in jimma university specialized hospital, southwest ethiopia.

Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for urinary tract infections and their resistance patterns may help the clinician to choose the correct empirical treatment. Therefore, the aim of this study was to determine the type and antibiotic resistance pattern of the urinary pathogens isolated from patients attending Jimma University Specialized Hospital from April to June 2010. A hospital based cross sectional stud was conducted and urine samples were collected using the mid-stream "clean catch" method from 228 clinically-suspected cases of urinary tract infections and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for the isolated pathogens using Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. Significant bacteria were detected from 9.2% of the total patients. The most common pathogens isolated were Escherichia coli (33.3%), Klebsiella pneumoniae (19%) and S. saprophyticus (14.3%). E. coli and Klebsiella pneumoniae showed the highest percentage of resistance to ampicillin and amoxacillin (100%) however, all isolates of E. coli and K. pneumoniae were susceptible to ciprofloxacin. S. saprophyticus and S. aureus were resistant to ampicillin (100%) and amoxicillin (66.7%). For all UTI isolates, least resistance was observed against drugs such as ceftriaxone, gentamycin and chloramphenicol. This study finding showed that E. coli isolates were the predominant pathogens and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs that in turn leaves the clinicians with very few alternative options of drugs for the treatment of UTIs. As drug resistance among bacterial pathogens is an evolving process, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs.

Restless legs syndrome, with particular reference to its occurrence after gastric surgery.

There is a higher incidence of restless legs syndrome (Ekbom's syndrome) in patients after gastric surgery (11.3%) and with diabetes mellitus (17.0%) and uraemia (17.3%) than in patients who have been diagnosed as having a psychonoeurosis (4.0%) and in controls (2.0%). Three patients with malabsorption syndrome complained of restless legs, but these patients had abnormal neurological signs. The incidence after gastric surgery and in diabetes mellitus and uraemia remained high even when patients with any abnormal neurological signs were excluded.