Antibiotic treatment and antimicrobial resistance in children with urinary tract infections

Vazouras, Konstantinos; Velali, Kyriaki N; Tassiou, I.; Anastasiou-Katsiardani, Anastasia; Athanasopoulou, Katerina; Barbouni, Anastasia; Jackson, Charlotte; Folgori, Laura; Zaoutis, Theoklis; Basmaci, Romain; Hsia, Yingfen

doi:10.1016/j.jgar.2019.06.016

Cited by 60 publications

(59 citation statements)

References 26 publications

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“…Of the 331 patients, 184 (55.58%) were female compared with a study of Vazouras et al where the female proportion was 72.2% (22). The cause may be the higher rate of urinary tract abnormalities in our study group.…”

Section: Discussioncontrasting

confidence: 51%

Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania

Duicu

Cozea²,

Delean

et al. 2021

Exp Ther Med

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One of the most frequent bacterial infections in children are urinary tract infections (UTIs). In recent years, an increasing incidence of UTIs caused by resistant bacterial strains has been observed, especially with extended-spectrum β-lactamase-producing Enterobacteriaceae that represent about 15% of UTIs. A retrospective study was performed comprising 331 pediatric cases with UTI. Our study aimed to detect the resistance of the uropathogens to common drugs used in UTI treatment. High resistance rates have been recorded for ampicillin, amoxicillin, trimethoprim/sulfamethoxazole (TMP/SMX), cefuroxime, and ciprofloxacin, among E. coli and Klebsiella. The multidrug-resistance (MDR) rate was detected in one-third of the uropathogens, among which more than half were isolated in patients with urinary tract abnormalities. Our study highlighted that nitrofurantoin, ceftriaxone, amikacin and carbapenem may be used for the empirical treatment for febrile or complicated UTI in children. This is the first comprehensive study that evaluates antibiotic resistance in UTIs in children, and their association with urinary tract abnormalities in Romania. As a result of this research, the protocol for initial empiric treatment of infants with febrile or complicated UTI should be modified considering a detailed and ongoing monitoring of local sensitivity of uropathogens to antimicrobial agents.

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Section: Discussioncontrasting

confidence: 51%

Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania

Duicu

Cozea²,

Delean

et al. 2021

Exp Ther Med

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“…Worldwide, there is gradual increase in antimicrobial resistance among uropathogens, in one of the study conducted in 2008 had found that E. coli was resistant against ampicillin cotrimoxazole, ciprofloxacin, gentamicin, nitrofurantoin and amikacin (92%), (80%), (62%), (47%), (20%) and (4%) respectively. 19 Whereas, in our study resistance percentage against ciprofloxacin was 76% and Amikacin 9%, which is alarming in the region. In another study E.coli isolates were found susceptible to carbapenems (100%), amikacin (98.1%), cephalosporins, (96.2%) and piperacillin-tazobactam (88.5%), whereas fluoroquinolones were found highly potent against E.coli, but rate of high resistance to ciprofloxacin has also been observed.…”

Section: Disscussioncontrasting

confidence: 52%

Culture and PCR based detection of bacteria causing urinary tract infection in urine specimen

et al. 2020

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Objectives: Urinary tract infections are the second most common bacterial infections occurring at all ages and both sexes. The increasing rate of antibiotic resistance is a global concern. The use of routinely used antibiotics is resulting in treatment failure. The objective of this study was to diagnose the urinary tract infections by routine culture sensitivity test and by molecular methods. Methods: This study was conducted in Microbiology laboratory, Bolan Medical Complex Hospital, Quetta, from July 1st to 31st March 2019. Isolates were identified biochemically by API20E & API20NE. Antibiogram was performed using disc diffusion Kirby Bauer technique. The 16S rDNA gene approach was used for molecular identification of bacterial isolates. The presence of the blaNDM-1 gene was identified by polymerase chain reaction (PCR). Results: We isolated 146 bacterial isolates namely Escherichia coli (n=99) 67.80%, Klebsiella pneumoniae (n=33) 22.60%, Pseudomonas aeruginosa (n=11) 7.53% and Proteus mirabilis (n=3) 2.05% from 2032 urine samples. The resistance pattern was dominated by Multi Drug Resistance (MDR). Remarkably, four isolates of Escherichia coli (n=3) and Klebsiella pneumoniae (n=1) were displaying resistance against a range of antibiotics used in the study, including carbapenems but sensitive to tigecycline and polymyxins only, suggesting extensive drug resistance having blaNDM-1 gene. Conclusion: This is the first report on direct molecular detection of bacterial pathogens from urinary tract infected patients in Balochistan. The presence of blaNDM-1 in different bacterial species and their extensive drug resistance pattern poses a significant clinical threat. Molecular detection of bacteria and resistant gene may reduce the diagnostic time of patients. doi: https://doi.org/10.12669/pjms.36.3.1577 How to cite this:Pirkani GS, Awan MA, Abbas F, Din M. Culture and PCR based detection of bacteria causing urinary tract infection in urine specimen. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1577 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“… 20 Comparable prevalence rate of MDR uropathogens to commonly prescribed antimicrobials has also been reported by some recent studies. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh

Dasgupta¹,

Rafi

Salam

2020

Pak J Med Sci

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Objectives: Urinary tract infections due to multi drug resistant bacteria have been on the rise globally with serious implications for public health. The objective of this study was to explore the prevalence of multi drug resistant uropathogens and to correlate the urinary tract infections with some demographic and clinical characteristics of patients admitted in a tertiary care hospital in Bangladesh. Methods: A cross sectional prospective study was conducted at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh among clinically suspected urinary tract infection patients from January to December, 2018. Clean-catch midstream or catheter-catch urine samples were subjected to bacteriological culture using chromogenic agar media. Antimicrobial susceptibility testing of the isolates was done by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Descriptive statistical methods were used for data analysis. Results: Culture yielded a total of 537 (42.8%) significant bacterial growths including 420 (78.2%) multi drug resistant uropathogens from 1255 urine samples. Escherichia coli was the most common isolate (61.6%) followed by Klebsiella spp. (22.5%), Pseudomonas spp. (7.8%), Staphylococcus aureus (5.4%) and Enterobacter spp. (2.6%) with multi drug resistance frequency of 77.6%, 71.9%, 90.5%, 86.2% and 92.9% respectively. There was female preponderance (M:F; 1:1.97; P=0.007) but insignificant differences between paediatric and adult population (43.65% vs. 42.57%) and also among different age groups. Diabetes, chronic renal failure, fever and supra-pubic pain had significant association as co-morbidities and presentations of urinary tract infections (P<0.05). Multi drug resistance ranged from 3.7 to 88.1% including moderate to high resistance found against commonly used antibiotics like ciprofloxacin, cephalosporin, azithromycin, aztreonam, cotrimoxazole and nalidixic acid (28.6 to 92.9%). Isolates showed 2.4 to 32.2% resistance to nitrofurantoin, amikacin, netilmicin and carbapenems except Pseudomonas spp. (66.7% resistance to nitrofurantoin) and Enterobacter spp. (28.6 to 42.9% resistance to carbapenems). Conclusion: There is very high prevalence of multi drug resistant uropathogens among hospitalized patients and emergence of carbapenem resistance is an alarming situation. Antibiotic stewardship program is highly recommended for hospitals to combat antimicrobial resistance. doi: https://doi.org/10.12669/pjms.36.6.2943 How to cite this:Dasgupta C, Rafi MA, Salam MA. High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2943 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Antibiotic treatment and antimicrobial resistance in children with urinary tract infections

Cited by 60 publications

References 26 publications

Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania

Antibiotic resistance patterns of urinary tract pathogens in children from Central Romania

Culture and PCR based detection of bacteria causing urinary tract infection in urine specimen

High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh

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