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.

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.

scholarly journals SYSTEMATIC REVIEW OF URINARY TRACT INFECTION CAUSED BY ACINETOBACTER SPECIES AMONG HOSPITALISED PATIENTS

2013 ◽  
Vol 03 (04) ◽  
pp. 007-009
Author(s):  
Sanjeev H. ◽  
Swathi N. ◽  
Asha Pai ◽  
Rekha R. ◽  
Vimal K. ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Hospitalized Patients ◽  
High Morbidity ◽  
Acinetobacter Species ◽  
Strict Adherence ◽  
Disseminated Infection ◽  
Hospitalised Patients ◽  
Hospital Infection Control ◽  
Tract Infections ◽  
Culture Positive

Abstract Introduction:Acinetobacter species have emerged as important nosocomial pathogens and have been known to cause different kinds of opportunistic infections. Acinetobacter species cause a wide variety of illness in debilitated and hospitalized patients especially in intensive care units (ICU). Because of frequent resistance to aminoglycoside's, fluoroquinolone's, ureidopenicillin's and third generation cephalosporin's, carbapenem are important agents in managing Acinetobacter infections. Material and Methods: A systematic retrospective analysis was performed on culture positive urinary tract infections among hospitalized patients between January 2010-December 2012. Significant isolates of Acinetobacter species were included in the study and was further analyzed for antimicrobial susceptibility, associated risk factors, underlying debility and co-morbid conditions. Results:Among the 2240 culture positive samples, Acinetobacter species was isolated from 46 patients with UTI. Tigecyline was found to be the antibiotic with highest susceptibility (91%) followed by Imipenem(69.5%), Meropenem (67.3%) and Gatilfoxacin (63%). The six patients who expired had disseminated infection with highly resistant strains of Acinetobacter species. Mechanical ventilation was the predominant risk factor for severe and disseminated infection. Conclusion:Acinetobacter infections are associated with high morbidity and mortality. Multidrug resistant Acinetobacter are common in hospitals, especially in ICU's. A feasible hospital antibiotic policy and strict adherence to it, rigorous surveillance and good hospital infection control programme is needed to control the increasing incidence of highly resistant Acinetobacter infections.

scholarly journals Prevalence and antibiotic susceptibility pattern of pathogens from urinary tract infections (UTI) in a private diagnostic laboratory in Bangladesh

2020 ◽  
Vol 6 (3) ◽  
pp. 564-569
Author(s):  
Md Habibur Rahman ◽  
Mushtaque Ahmed ◽  
Dayanidhi Sarkar ◽  
Md Asadur Rahman
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antibiotic Susceptibility ◽  
Antimicrobial Agents ◽  
Urine Samples ◽  
Gram Positive ◽  
Diagnostic Laboratory ◽  
Gram Negative ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

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 pathogens with increasing resistance to antimicrobial agents. The aim and objectives of this study were to determine the pathogens causing UTI and to determine the antibiotic sensitivity status among these isolates in a diagnostic laboratory in Dhaka city. A laboratory based cross sectional survey was conducted in Popular Diagnostic Centre Ltd. Dhanmondi, Dhaka-1205, Bangladesh from July 2016 to December 2016. A total of 553 freshly voided midstream urine samples (10-20 ml) were collected in a wide mouth sterile container from patients and processed in microbiology laboratory to isolate pathogens and antibiotic susceptibility test using standard procedure. Among 553 urine sample, the culture positivity in urine samples was found to be 158 (28.57%) of which 39 (24.70%) were isolated from male patients and 119 (75.30%) from female patients. Escherichia coli (43.67%) were found to be the predominant pathogen followed by Staphylococcus spp. (16.45%), Enterococcus spp. (13.39%), Klebsiella spp. (13.29%), Candida spp. (5.70%), Acinetobacter spp. (4.43%), Psudomonas spp. (3.80%) and Proteus spp. (1.27%). Carbapenem group (Imipenem, Meropenem) were the most effective antibiotic with resistance between 0 and 5.1% of the gram negative isolates and Linezolid and Vancomycin was most effective in gram positive isolates. Nitrofurantoin was most effective both gram negative and gram positive isolates. This study finding showed That Escherichia. coli isolates were the predominant pathogens and showed increasing pattern to the commonly prescribed drugs in private practice that in turn leaves the clinicians with very few alternative options in drug for the treatment of UTIs. Asian J. Med. Biol. Res. September 2020, 6(3): 564-569

scholarly journals Bacteriological Profile of Urinary Tract Infections among Postmenopausal Women Visiting Alka Hospital, Lalitpur, Nepal

2018 ◽  
Vol 2 ◽  
pp. 34-40
Author(s):  
Surendra Prasad Yadav ◽  
Puspa Raj Dahal ◽  
Shiv Nandan Sah ◽  
Vijay Kumar Sharma
Keyword(s):  
Urinary Tract ◽  
Postmenopausal Women ◽  
Antibiotic Susceptibility ◽  
Urine Samples ◽  
Diffusion Method ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Microbiological Methods ◽  
Tract Infections

Urinary tract infection (UTI) is one of the most common diseases encountered worldwide and is a major public health problem in terms of morbidity and financial costs. A cross-sectional study was conducted in Alka Hospital, Lalitpur, Nepal from February to July, 2014. A total of 353 midstream urine samples were collected from postmenopausal women visiting Alka Hospital, Lalitpur, Nepal. The samples were examined by microscopically and culture methods. The isolated organisms were identified by conventional microbiological methods. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method according to CLSI (2011) guidelines. Among 353 urine samples processed, 32 % (113) showed significant bacteriuria. Out of 113 bacterial isolates, the prevalence of gram negative bacteria was 97.3% (110) while that of gram positive was 2.7% (3). The most predominating organisms causing UTI were Escherichia coli (84.9%) followed by Klebsiella pneumoniae (5.3%), Enterococcus faecalis (1.7%), Providencia spp. (1.7%), Klebsiella oxytoca (1.7%), Proteus mirabilis (1.7%), Proteus vulgaris (0.9%), Citrobacter freundii (0.9%) and Staphylococcus aureus (0.9%). Antibiotic susceptibility tests of the isolates showed that, most of the gram negative bacterial isolates were sensitive to Piperacillin+Tazobactam followed by Amikacin, Imipenem and Nitrofurantoin, while they were resistant to Amoxicillin. All gram positive isolates were sensitive to Amoxicillin and resistant to Gentamycin. This study showed that higher aged postmenopausal women (>80 years) were at higher risk for UTI than those of lower aged ones (<80 years).

scholarly journals Urinary tract infections by multidrug resistant Acinetobacter species- A Retrospective Analysis

2018 ◽  
Vol 08 (03) ◽  
pp. 017-024
Author(s):  
Prashant Mule ◽  
Niranjan Patil ◽  
Seema Gaikwad
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Resistant Bacteria ◽  
Routine Practice ◽  
Polymorphonuclear Leucocytes ◽  
Acinetobacter Species ◽  
Therapeutic Decisions ◽  
Tract Infections

Abstract Background: Acinetobacter species have emerged as important cause of nosocomial infections like pneumonia and urinary tract infections. Acinetobacter species are known to be highly resistant to commonly used antimicrobial agents. SinceAcinetobacter species are ubiquitous and have tremendous colonizing capacity, it is difficult to explain the role of Acinetobacter acquisition in the ICU and medical wards. The objective of this study was to determine the frequency of urinary tract infection (UTI) caused by different Acinetobacter species in hospitalized patients and in the community and to analyze their antimicrobial susceptibility pattern. Materials and Methods: This is a retrospective analysisfrom January 2016 to December 2017. Urine samples collected in appropriate sterile manner were screened for polymorphonuclear leucocytes and bacteria by routine microscopic examination. This was followed by plating on MacConkey's agar and Blood agar. Isolated Acinetobacter strains which are oxidase negative and non-lactose fermenters from MacConkey's agar were identified with Matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) to confirm the TM identification. Antibiotic susceptibility was performed by VitekCompact™ 2 (Biomeuriux, France) as per CLSI standards establishing MIC (Minimum Inhibitory Concentration). Results: Of the 429 isolates of Acinetobacterspecies from urinary tract, Acinetobacterbaumannii complex (78%) found to be the most common species followed by Acinetobacterjunii(10%) and Acinetobacterbaumannii(8%). Of the 334 (78%) isolates of Acinetobacterbaumannii complex from urinary tract, 73 (21.85%) isolates were resistant with doripenem, 62 (18.56%) with imipenem and 59 (17.66%) were resistant with meropenem with MIC values >=8 μg/ml. The rest of the isolates like Acinetobacterjunii, Acinetobacterjohnsonii, andAcinetobacterlwoffiiare found to be more sensitive with carbapenems with lower MIC values. Discussion: The treatment of multidrug-resistant bacteria in hospitalized patients continues to be a challenge for the clinician's in routine practice. Acinetobacter baumannii complex has proven to be an important pathogen in health care associated infections with significant mortality and morbidity. The drug resistant nature of the pathogen and its unpredictable susceptibility patterns make empirical and therapeutic decisions even more difficult. Conclusion: A. baumanniiis an important opportunistic agent of nosocomial UTI, especially in patients with longer hospitalization, antibiotic exposure, urinary catheterization and decreased immunity. High antimicrobial resistance and patient co-morbidities limit therapeutic choices. Hence, alternative therapeutic options are urgently needed to treat a patient with A. baumanniiinfection.

Secular Trends in Gram-Negative Resistance among Urinary Tract Infection Hospitalizations in the United States, 2000–2009

2013 ◽  
Vol 34 (9) ◽  
pp. 940-946 ◽  
Author(s):  
Marya D. Zilberberg ◽  
Andrew F. Shorr
Keyword(s):  
United States ◽  
Urinary Tract ◽  
The United States ◽  
Secular Trends ◽  
Hospitalized Patients ◽  
Resistance Pattern ◽  
Surveillance Network ◽  
Gram Negative ◽  
Nationwide Inpatient Sample Database ◽  
Tract Infections

Objective.Urinary tract infections (UTIs) are common among hospitalized patients. Selection of an appropriate antibiotic for this infection requires knowledge of both its general microbiology and the epidemiology of drug-resistant organisms. We sought to determine secular trends in UTI hospitalizations that involve gram-negative (GN) multidrug-resistant Pseudomonas aeruginosa (MDR-PA), extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (EC) and Klebsiella pneumoniae(KP), and carbapenem-resistant Enterobacteriaceae (CRE).Design.Survey.Patients.Patients with UTI in US hospitals between 2000 and 2009.Methods.We first derived the total number of UTI hospitalizations in the United States from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database years 2000–2009. Based on a literature review, we then determined what proportion of all UTIs arise due to each of the organisms of interest, irrespective of resistance pattern. Finally, we assessed the prevalence of resistance within each pathogen based on the Eurofins Surveillance Network database 2000–2009. Susceptibility patterns served as phenotypic surrogates for resistance.Results.Between 2000 and 2009, the frequency of UTI hospitalizations increased by approximately 50%, from 53 to 77 cases per 1,000 hospitalizations. Infections due to all GN bacteria followed a similar trajectory, whereas those caused by resistant GN pathogens increased by approximately 50% (MDR-PA) to approximately 300% (ESBL). CRE emerged and reached 0.5 cases per 1,000 hospitalizations in this 10-year period.Conclusions.The epidemiology and microbiology of GN UTI hospitalizations has shifted over the past decade. The proportion of all hospitalizations involving this infection has climbed. Resistant GN bacteria are becoming more prevalent and are implicated in an increasing proportion of UTIs among hospitalized patients.

scholarly journals Profiling urinary tract infections bacteria among elderly population in a Nigerian Teaching Hospital

2018 ◽  
Vol 6 (3) ◽  
pp. 15-22
Author(s):  
S. A. Saka ◽  
B. E. Okunuga
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Teaching Hospital ◽  
University Teaching ◽  
Resistance Pattern ◽  
Biomedical Sciences ◽  
Significant Bacteriuria ◽  
Tract Infections ◽  
Urine Specimens

There have been conflicting reports about prevalence of Urinary Tract Infections (UTIs) causing bacteria in elderly in recent times. This study aims to evaluate the prevalence and resistance pattern of UTIs causing bacteria in elderly Nigerian patients. A prospective cross-sectional study was carried out among elderly patients attending the general and medical outpatients’ clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Patients aged 60 years and above with at least two signs of UTIs were purposefully selected for the study. Clean catch mid-stream urine specimens from 100 eligible patients were examined for significant bacteriuria. Identification and antibiotics susceptibility patterns of the isolates were determined using standard techniques. Data were analysed using descriptive statistics such as frequency and percentage. Association between variables was determined using Chi-squared test. P values<0.05 were considered significant. One hundred elderly outpatients were evaluated. Majority of the study participants were males (68, 68.0%) and (64, 64.0%) were married. More than half of the participants (59, 59.0%) had no significant bacteriuria. Among the participants with significant bacteriuria (41, 41.0%), males (29/41, 70.7%, p=0.001) were more than the females (12, 29.3%). Klebsiella pneumoniae (19/41, 46.3%) was the most isolated organism in the participants’ urine specimens, (35/41, 85.4%) of the isolates were resistant to nitrofurantoin. Klebsiella pneumoniae was the most isolated UTIs-causing bacteria among the elderly evaluated. Physicians need to be aware of trends in profiles of UTIs-causing bacteria for effective diagnosis of the disease in elderly.Journal of Medical and Biomedical Sciences (2017) 6(3), 15 - 22

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