scholarly journals Resistance among Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal and urinary tract infections in Latin American countries: SMART 2013–2015

2017 ◽  
Vol 21 (3) ◽  
pp. 343-348 ◽  
Author(s):  
James A. Karlowsky ◽  
Daryl J. Hoban ◽  
Meredith A. Hackel ◽  
Sibylle H. Lob ◽  
Daniel F. Sahm
Keyword(s):  
Urinary Tract ◽  
Latin American ◽  
Urinary Tract Infections ◽  
Hospitalized Patients ◽  
Gram Negative ◽  
Tract Infections ◽  
Eskape Pathogens ◽  
Latin American Countries

scholarly journals 1433. Predictive Models for Antibiotic Coverage of Gram-Negative Urinary Tract Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S523-S523
Author(s):  
Courtney Hebert ◽  
Yuan Gao ◽  
Protiva Rahman ◽  
Courtney M Dewart ◽  
Nirav Shah ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Predictive Models ◽  
Hospitalized Patients ◽  
Validation Dataset ◽  
Point Estimate ◽  
Gram Negative ◽  
Validation Set ◽  
Tract Infections ◽  
Antibiotic Coverage

Abstract Background Providers use institutional recommendations, national guidelines, and antibiograms to decide on empiric antibiotics. As local antibiograms are most effective after organisms are known, we sought to use local microbiology and clinical data to develop predictive models for antibiotic coverage prior to identifying the organism. We focused on Gram-negative organisms as they are common urinary pathogens and are often the cause of sepsis originating in the urinary tract. As such, they are important to cover in hospitalized patients with urinary tract infections (UTI). Methods Hospitalized patients, with a diagnosis of UTI and a positive urine culture in the first 48 hours were included. Gram-positive organisms, yeast, and cultures without susceptibilities were excluded. Unknown susceptibilities were filled in using expert-derived rules. Clinical information from electronic health record (EHR) data were extracted on each patient. Penalized logistic regression with 10-fold cross validation was used to develop final models for coverage for five antibiotics (cefazolin, ceftriaxone, ciprofloxacin, cefepime, piperacillin–tazobactam). Final models were chosen based on their discrimination, calibration, and number of predictors, and then tested on a held-out validation dataset. Results Included were 5,096 patients (80% training; 20% validation). Coverage ranged from 65% for cefazolin to 90% for cefepime. Positive blood cultures were present in 544 (11%) with 388 (71%), including a urinary pathogen. In the first 24 hours, 2329 (46%) were hypotensive, 2179 (43%) had a respiratory rate > 22, 2049 (40%) had a WBC > 12, 1079 (21%) were febrile, and 584 (11%) required ICU care. Final model covariates included demographics, antibiotic exposure, prior resistant pathogens, and antibiotic allergies. The five predictive models had a point-estimate for the area under the ROC on the validation set that ranged from 0.70 for ciprofloxacin to 0.73 for ceftriaxone. Conclusion In this cohort of moderate to high acuity hospitalized patients with Gram-negative urinary pathogens, we used EHR data to develop 5 models that predict antibiotic coverage which could be used to support empiric prescribing. These models performed well in a held-out validation set. Disclosures All authors: No reported disclosures.

scholarly journals Urinary Tract Infection Due to Non-fermentative Gram-Negative Bacilli in Tribhuvan University Teaching Hospital, Kathmandu, Nepal

NUTA Journal ◽  
2020 ◽  
Vol 7 (1-2) ◽  
pp. 71-78
Author(s):  
Santosh Kumar Yadav ◽  
Uday Kant Jha ◽  
Jeevan Bahadur Sherchan
Keyword(s):  
Urinary Tract ◽  
Teaching Hospital ◽  
Antibiotic Susceptibility ◽  
Hospitalized Patients ◽  
The Body ◽  
University Teaching ◽  
Burkholderia Cepacia Complex ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Tract Infections

Urinary tract infections (UTIs) are the second most common type of bacterial infection of the body affecting humans throughout their lifetime. They are a frequent cause of nosocomial in fection in many hospitals. Therefore, this study was designed to isolate and identify the non-fermentative Gram-negative bacilli (NFGNB) causing UTI in hospitalized patients and determine their antibiotic susceptibility profile. This study was carried in Tribhuvan University Teaching Hospital, Nepal among hospitalized patients. The urine sample was cultured and the antibiotic susceptibility profile of isolated NFGNB was determined by standard microbiological procedures. Among the total of 49 NFGNB isolates, Acinetobacter species (n=21, 42.9%) and Pseudomonas aeruginosa (n=21, 42.9%) were the major isolates and the remaining was Burkholderia cepacia complex (n=7, 14.3%). These isolates were found resistant to commonly used antibiotics. From the present study, it is clear that NFGNB are an important bacterial pathogen capable of producing UTI in hospitalized patients.

scholarly journals Morganella morganii, subspecies morganii, biogroup A: An unusual causative pathogen of brain abscess

2012 ◽  
Vol 03 (03) ◽  
pp. 370-372 ◽  
Author(s):  
Asha B. Patil ◽  
Shobha D. Nadagir ◽  
S. A. Lakshminarayana
Keyword(s):  
Urinary Tract ◽  
Brain Abscess ◽  
Urinary Tract Infections ◽  
Unusual Case ◽  
Causative Pathogen ◽  
Morganella Morganii ◽  
Gram Negative ◽  
Cns Infections ◽  
Tract Infections ◽  
High Index Of Suspicion

ABSTRACT Morganella morganii is a gram negative aerobe , found often as intestinal commensal. It is commonly implicated in Urinary tract infections and pyogenic infections, but rarely causes CNS infections especially brain abscess. There are very few published reports of Morganella morganii as a causative pathogen in brain abscess. High index of suspicion of this pathogen is important in cases of brain abscess secondary to otogenic infections. This paper reports an unusual case of Morganella morganii, subspecies morganii, biogroup A Brain abscess .The paper also reviews other infections caused by Morganell morganii.

Antibiogram of Gram Negative Uropathogens in a Tertiary Care Hospital

2021 ◽  
Vol 8 (2) ◽  
pp. 80-84
Author(s):  
Milind Davane ◽  
Sanjivani Mundhe
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Susceptibility ◽  
Hospitalized Patients ◽  
Health Concern ◽  
Diffusion Method ◽  
Susceptibility Pattern ◽  
Gram Negative ◽  
Antimicrobial Susceptibility Pattern ◽  
Tract Infections ◽  
Klebsiella Spp

Background: Globally, urinary tract infection (UTI) is considered a major public health concern and the second most common bacterial infection affecting individuals of different ages worldwide. Urinary tract infections (UTIs) are caused by multiplicity of microorganisms. The chronicity of different bacterial isolates and their propensity to various antibiotics may differ widely, particularly in hospitalized patients, that makes the study of susceptibility pattern mandatory for a proper selection of antibiotics. Objective: To evaluate antimicrobial susceptibility pattern of the Gram negative organisms isolated from urine cultures of hospitalized patients. Material and Methods: A total of 500 urine samples from hospitalized patients which showed significant bacteriuria were studied. Samples were inoculated on Blood agar and MacConckey agar. Further identification and study of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was studied by Modified Kirby- Bauer’s disc diffusion method with the panel of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) guidelines. Results: UTIs were found more common in females 290 (58%). Commonest organism found was Escherichia coli 260 (52%) followed by Klebsiella spp. 120 (24%), Pseudomonas spp. 40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp. 25 (5%) and Acinetobacter spp. 17 (3.4%). Majority of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactam and cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp. Conclusion: To discourage the indiscriminate use of antibiotics and to prevent further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapy.

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