scholarly journals Urinary Tract Infection Associated with Multidrug-Resistant Bacteria in a Second level Hospital During a Two Year Period

2018 ◽  
Vol 3 (4) ◽  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Mortality Rate ◽  
Tract Infection ◽  
Chronic Renal Disease ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Bacteria Growth ◽  
Tract Infections

Objective: determine the frequency of urinary tract infections associated with MDR bacteria, characteristics patients with such infections and the mortality rate associated in Hospital ISSSTECALI during 2015-2016. Design: Descriptive, observational, analytic, transversal Methods: We collected data from clinical files of each patient that had been diagnosed with a urinary tract infection and had an uroculture of 10x105 CFU of bacteria with a multidrug-resistant profile. It included, gender, age, comorbidities, predisposing risk factors, obtained isolation, sensibility pattern, days of stay and proper technique of culture. We calculated frequencies and rates. Results: During January 2015- November 2016 a total of 2401 urocultures were solicited, we isolated bacteria in 123 of them (5.12%). 94 urocultures were included, 71% of the cultures were from women with a median age of 68.14 years; comorbidities: Hypertension (50%), diabetes (41.5%), chronic renal disease (14.9%), history of stroke and bed-rest. An average of 14.15 days of stay was calculated. They all had a urinary catheter. Of the total of urocultures obtained, 54 urocultures demonstrated bacteria growth with a MDR phenotype (attack rate: 0.43 cases/1000 discharges) Escherichia coli was isolated in 26 (48.14%) cultures; Pseudomona aeruginosa 7.4%; and Klebsiella pneumonia 5.5%; its mechanism of resistance was calculated according to the reported phenotype on the antimicrobiogram, demonstrating resistance to more than two family of antibiotics. A mortality rate of 21.3% was calculated of which the direct cause was related to the infective process (rate: 0.23 deaths/1000 discharges). Conclusion: the isolation of bacteria with a multidrug-resistant profile is not very common; however, they generate a high morbimortality index and a great weight in resources to our unit. Recommendations: reinforcement of programs that encourage rational use of antibiotics as well as the control of nosocomial infections should be employed in the hospital.

scholarly journals Multi Drug Resistance (MDR) Urinary Tract Infection: An Evidence Based Study

2021 ◽  
Vol 15 (6) ◽  
pp. 1910-1913
Author(s):  
Nasir Orakzai ◽  
Liaqat Ali ◽  
Majid Khan Kakakhel ◽  
Arshad . ◽  
Faiza Hayat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Treatment Cost ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
The Mean ◽  
Tract Infections

Background: Urinary tract infections are the most frequently reported infections that drive the use of antibiotics around the world. UTI is the 4th most common healthcare-associated infection. Multidrug-resistant (MDR) organisms are predominantly bacteria that are resistant to one or more classes of antimicrobials. The increasing rise in the incidence of MDR-UTI has resulted in increased morbidity, mortality, and treatment cost of the patients. Thus, it is important to highlight the magnitude of the problem, identify the risk factors that result in MDR-UTI, and to take appropriate measures to control its occurrence. Objective: To determine the magnitude of the multidrug-resistant bacteria, their antibiotic-resistant profile, andtheir effect on the treatment cost of the patients Methods: It is a descriptive study conducted in the Department of Urology at the Institute of Kidney Diseases (IKD) from Jan 2019 till 30th March 2020. A total of 54 patients with multi-drug resistant UTI were included in the study irrespective of age and gender. All the data was recorded on a structured pro-forma and was analyzed on SPSS. Results: A total of 3190 patients were operated on from Jan 2019 till 30th March 2020. Out of which 54 patients (1.6 %) developed MDR-UTI. Among them,38 were male and 16 females. The mean age of the patients was 41 ± 18.4. Urolithiasis with infections was found most frequent, in 32 (59.3%) patients. All patients were on broad-spectrum oral antibiotics and had a history of urethral catheterization before the development of MDR-UTI. The most common procedure was Emergency cystoscopy and DJ stent 15 (27.8%). Followed by Percutaneous nephrostomy in 8 (14.8%). Regarding co-morbidities, 38(68.5%) patients had none, 3 patients had diabetes and 6 patients were having Diabetes and Hypertension. Pseudomonas aeruginosa was found most frequent microorganisms in 34 (63%) patients while E.coli in 10 (18.5%) and Klebsiella in 5 (9.3%) patients. Colistin was found sensitive in 36 patients (66.7%). The mean hospital stay in MDR-UTI is 9.28± 5.17 days as compared to 2.1 days in routine cases. Approximately a 4-fold increase was observed in medicines alone in the management of MDR UTI. We recorded 1 mortality (1.9%), case of MDR urosepsis. Linear regression revealed previous use of antibiotics; catheterization, old age, and endo-urological procedures in an emergency as independent risk factors for MDR-UTI. Conclusion: MDR-uti is an emerging local problem. pseudomonas aeruginosa is the most frequently found microorganism in the present setup. it is associated with significant morbidity and very high treatment cost. Keywords: Urinary Tract Infection, Multidrug Resistance, Micro-Organism, Urology, Antimicrobials

scholarly journals Risk factors of multidrug-resistant bacteria in community-acquired urinary tract infections

2021 ◽  
Vol 21 (1) ◽  
pp. 214-9
Author(s):  
Ertugrul Guclu ◽  
Fikret Halis ◽  
Elif Kose ◽  
Aziz Ogutlu ◽  
Oğuz Karabay
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Antibiotic Usage ◽  
Advanced Age ◽  
History Of ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are one of the most seen infection among community. Objectives: In this cross-sectional study we aimed to investigate the risk factors of multidrug-resistant (MDR) bacteria that caused community-acquired UTI (CA-UTI). Methods: Consecutive patients admitted to the Urology and Infectious Diseases policlinics with the diagnosis of CA-UTI were included in the study. A standard form including possible predisposing factors for MDR bacteria was applied. Results: In total, 240 patients (51.3% females) were enrolled in the study. The mean age of participants were 59.8 ± 18.3 years old. Escherichia coli (n =166; 69.2%)was the most frequently isolated bacteria and its incidence was higher in females than in males (p=0.01). In total, 129 (53.8%) of the identified pathogens were MDR bacteria. According to multivariate analysis, the use of antibiotics three or more times increased the risk of infection with MDR bacteria by 4.6 times, the history of urinary tract infection in the last 6 months by 2 times, being male and over 65 years old by 3 times. Conclusion: Doctors should consider prescribing broad-spectrum antibiotics in patients with severe UTIs with a history of UTI, advanced age, male gender, and multiple antibiotic usage, even if they have a CA-UTI. Keywords: Urinary tract infection; community acquired; multidrug-resistant; male; multiple antibiotic usage; advanced age.

scholarly journals Prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection among the patients attending outpatient department of Seti Zonal Hospital, Dhangadi, Nepal

2015 ◽  
Vol 3 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Tek Raj Awasthi ◽  
Narayan Dutt Pant ◽  
Puspa Raj Dahal
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Past History ◽  
Multidrug Resistant ◽  
Outpatient Department ◽  
Public Health Issue ◽  
Resistant Bacteria ◽  
Biochemical Tests ◽  
Multidrug Resistant Bacteria

Involvement of multidrug resistant bacteria in causing community acquired infection is very serious public health issue. The main objective of our study was to determine the prevalence of multidrug resistant bacteria in causing community acquired urinary tract infection. In this study we cultured the 384 mid stream urine samples collected aseptically from the patients attending outpatient department of Seti zonal hospital and having no past history of hospitalization. The organisms isolated were identified by using conventional biochemical tests and antimicrobial susceptibility testing was performed by Kirby Bauer disc diffusion technique. Out of total 384 samples 98 (25.52%) samples showed significant bacterial growth. The most prevalent bacterium isolated was Escherichia coli. 42.86% of the bacteria isolated were found to be multidrug resistant (MDR). The involvement of such large numbers of multidrug resistant bacteria in causing community acquired urinary tract infection is very serious issue and cannot be neglected. And some abrupt initiatives should be taken by the responsible authorities to improve or at least avoid the further worsening of the situation.Nepal Journal of Biotechnology. Dec. 2015 Vol. 3, No. 1: 55-59

scholarly journals Per Urethral Catheterisation: Microbial Growth Incidence and its Management

2014 ◽  
Vol 2 (03) ◽  
pp. 105-111
Author(s):  
M. Singh ◽  
P. Kothiyal ◽  
P. Mathur
Keyword(s):  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Incidence Rate ◽  
Microbial Growth ◽  
Resistance Pattern ◽  
Klebsiella Pneumonia ◽  
Sensitivity Pattern ◽  
Tract Infections

The urinary tract is the most common site of nosocomial infections accounting for more than 40% of the total number reported by acute care hospitals and affecting approximately 600,000 patients per year. Catheter Associated Urinary Tract Infection (CAUTI) defines in terms of “bacteriuria” and “urinary tract infection” frequently. Bacteriuria or funguria levels >103 colony- forming units (CFU) have been shown to be highly predictive of CAUTI, given that these levels increase to 105 CFU within 24 to 48 hours. In Indian population, catheterassociated urinary tract infection (CAUTI) is an important cause of morbidity and mortality, affecting all age groups. Biofilm is the predominant mode of growth in aquatic ecosystems and, as such, plays a central role in the pathogenesis of Catheter Associated Urinary Tract Infections (CAUTI). The present review focuses to evaluate the incidence and pattern of microbes in catheter associated urinary tract infection and provides information about the etiology of CAUTI. Most of the studies concluded that gram negative pathogen E.coli showed the highest incidence rate and other pathogens like Klebsiella pneumonia, Pseudomonas aeruginosa, and staphylococcus species also having the incidence rate in the patient having CAUTI. The antibiotic resistance pattern showed the variation in resistance and sensitivity of antibiotics against the pathogens. The present study focuses on the incidence of the microbial growth in patient having catheterization and also elucidates the antibiotic sensitivity pattern. It is necessary to determine the antibiotic resistance and sensitivity status during and after the catheterization.

scholarly journals Oral and Intravenous Fosfomycin for the Treatment of Complicated Urinary Tract Infections

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
George G. Zhanel ◽  
Michael A. Zhanel ◽  
James A. Karlowsky
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Therapeutic Option ◽  
Multidrug Resistant ◽  
Upper Urinary Tract ◽  
Lower Urinary Tract Infection ◽  
Effective Therapeutic Option ◽  
Tract Infections

Oral fosfomycin is approved in Canada for the treatment of acute uncomplicated cystitis. Several studies have reported “off label” use of oral fosfomycin in the treatment of patients with complicated lower urinary tract infection (cLUTI). This review summarizes the available literature describing the use of oral fosfomycin in the treatment of patients with cLUTI. Collectively, these studies support the use of a regimen of 3 grams of oral fosfomycin administered once every 48 or 72 hours for a total of 3 doses for patients who have previously failed treatment with another agent, are infected with a multidrug-resistant (MDR) pathogen, or cannot tolerate first-line treatment due to intolerance or adverse effects. Additionally, a Phase 2/3 clinical trial, known as the ZEUS study, assessed the efficacy and safety of intravenous (IV) fosfomycin versus piperacillin-tazobactam in the treatment of patients with complicated upper urinary tract infection (cUUTI) or acute pyelonephritis (AP) including in patients with concomitant bacteremia. IV fosfomycin was reported to be noninferior to piperacillin-tazobactam in treating patients with cUUTI and AP; however, when outcomes were independently evaluated according to baseline diagnosis (i.e., cUUTI versus AP), IV fosfomycin was superior to piperacillin-tazobactam in the treatment of patients with cUUTI and demonstrated superior microbiological eradication rates, across all resistant phenotypes including extended-spectrum β-lactamase- (ESBL-) producing Escherichia coli and Klebsiella spp. and carbapenem-resistant (CRE), aminoglycoside-resistant, and MDR Gram-negative bacilli (primarily Enterobacterales). Based on the ZEUS study, IV fosfomycin dosed at 6 grams every 8 hours for 7 days (14 days in patients with concurrent bacteremia) appears to be a safe and effective therapeutic option in treating patients with upper urinary tract infections, particularly those with cUUTI caused by antimicrobial-resistant Enterobacterales.

scholarly journals 1700. What Is Specific With Bacterial Escherichia Coli Urinary Tract Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S832-S833
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Fatma Smaoui ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Resistant Bacteria ◽  
Duration Of Treatment ◽  
Prostatic Abscess ◽  
The Mean ◽  
Tract Infections

Abstract Background Bacterial urinary tract infections continue to be a major health problem, responsible for a significant morbidity and mortality. Its prognosis is more severe than non-bacterial forms. The aim of this work was to study the clinical and evolutionary features of bacterial urinary tract infections caused by Escherichia coli (E.coli). Methods We conducted a retrospective study including all patients hospitalized in infectious diseases department for urinary tract infection (UTI) caused by E.coli between 2010 and 2017. Results During the study period, we enrolled 613 cases of UTI caused by E.coli, among whom 75 cases (12.2%) were bacterial. There were 47 females (62.7%). The mean age was 59 ±17 years. Thirty-three patients were aged ≥ 65 years (44%). Diabetes was noted in 38 cases (50.7%) and renal lithiasis in 14 cases (18.7%). A history of UTI was reported in 13 cases (17.3%). The most common clinical presentation was acute pyelonephritis (59 cases; 78.7%) and followed by prostatitis (8 cases; 10.6%). Renal abscess was noted in 5 cases (6.7%) and prostatic abscess in 3 cases (4%). There were 36 cases of multidrug-resistant bacteria (48%). Community-acquired UTI were noted in 70 cases (93.3%). The mean duration of treatment was 18 ± 6 days. Surgery and radiological drainage were indicated in 4 (5.3%) and 2 cases (2.7%), respectively. The outcome was favourable in 58 cases (77.3%). Complications were noted in 10 cases (13.3%) represented mainly by acute renal failure in 4 cases (5.3%). Relapse was noted in 9 cases (12%) and reinfection in 6 cases (8%). Two patients died (2.7%). Conclusion Bacterial urinary tract infections were associated to complications such as renal and prostatic abscess, requiring surgery and long duration of treatment. Disclosures All Authors: No reported disclosures

scholarly journals Isolation and Characterization of Multidrug Resistant Enterobacteriaceae in Urine Sample of Patients Suffering from Urinary Tract Infection with Diabetes and Nephropathy

2021 ◽  
Vol 20 (1) ◽  
pp. 87-93
Author(s):  
Nazmul Ahsan ◽  
Monzilur Rahman ◽  
Md Nazrul Islam ◽  
Anwarul Azim Akhand
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Diabetic Patients ◽  
Isolation And Characterization ◽  
Alternative Drug ◽  
Enterobacter Asburiae

Multidrug-resistant (MDR) organisms are spreading widely and becoming an issue of utmost importance to deal with. In the current study, ten urine samples from diabetic patients suffering from multiple complications, including urinary tract infection (UTI) and nephropathy were investigated. Antibiogram assays of the bacterial isolates from collected samples demonstrated resistance against most of the antibiotics tested. Further studies were conducted to determine the types of resistant bacteria that caused UTI. Analyzing the 16S rDNA sequence and phylogenetic tree, 3 isolates were identified as Escherichia coli, 5 as Klebsiella pneumoniae and the rest 2 as Enterobacter asburiae. The findings of this research indicate the necessity of urgent attention to find an effective alternative drug for treating infections caused by these resistant isolates. Dhaka Univ. J. Pharm. Sci. 20(1): 87-93, 2021 (June)

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