Biochemical Changes and Risk Factors in the Prognosis of Antibiotics Susceptibility in Urinary  Tract  Infections

Vâţă, A; Hunea, Ioana Maria; Dorneanu, Olivia; Harja-Alexa, Ioana Alina; Plesca, Claudia; Leonte-Enache, Georgiana; Ciocan, A; Ghiciuc, C.; Eşanu, Irina; Manolache, Mihai; Luca, Cătălina

doi:10.37358/rc.19.5.7223

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…The significant per capita antibiotic consumption in Romania, coupled with ineffective measures in terms of intra-hospital infection prophylaxis, is the basis for the increased rates of AMR in this geographical area. Both national and international multicenter studies support this hypothesis, mentioning that for some antimicrobials, epidemiological alerts have even been issued due to their alarming resistance rate [16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 92%

The Impact of Urinary Catheterization on the Antibiotic Susceptibility of ESBL-Producing Enterobacterales: A Challenging Duo

Miftode,

Vâță,

Miftode

et al. 2024

Antibiotics

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Introduction: Antimicrobial resistance (AMR) is currently a growing concern among healthcare providers, underscoring the importance of describing the regional susceptibility profile for common microorganisms that are associated with urinary tract infections (UTIs). This knowledge serves as the foundation for proper empirical therapeutic recommendations tailored to local susceptibility patterns. Results: We found a high prevalence of ESBL-producing strains (36.9%), with Escherichia coli and Klebsiella spp. being the most prevalent isolated bacteria. Among the catheterized patients, Klebsiella spp. emerged as the primary etiology, with a significant correlation between catheterization and Proteus spp. (p = 0.02) and Providencia stuartii (p < 0.0001). We observed significant correlations between urinary catheterization and older age (68.9 ± 13.7 years vs. 64.2 ± 18.1 years in non-catheterized patients, p = 0.026) and with the presence of an isolate with extensive drug resistance (p < 0.0001) or even pandrug resistance (p < 0.0001). Susceptibility rates significantly decreased for almost all the tested antibiotics during the study period. Notably, susceptibility was markedly lower among catheterized patients, with the most pronounced differences observed for carbapenems (59.6% versus 83.4%, p < 0.0001) and aminoglycosides (37.1% versus 46.9%, p = 0.0001). Materials and Methods: We conducted a retrospective study analyzing the susceptibility profiles of 724 extended-spectrum beta-lactamases (ESBL)-producing Enterobacterales isolated from urine cultures. Our focus was on highlighting susceptibility profiles among isolates associated with urinary catheterization and assessing the shifts in the susceptibility rates over time. Conclusions: The constant rise in AMR rates among Enterobacterales presents significant challenges in treating severe infections, particularly among urinary catheterized patients. This trend leaves clinicians with limited or no effective treatment options. Consequently, the development and implementation of personalized treatment protocols are imperative to ensure efficient empirical therapies.

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Section: Discussionmentioning

confidence: 92%

The Impact of Urinary Catheterization on the Antibiotic Susceptibility of ESBL-Producing Enterobacterales: A Challenging Duo

Miftode,

Vâță,

Miftode

et al. 2024

Antibiotics

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“…(34.5%) and Vata et al[17] (17.7%). We also found that catheterized patients with age ≤40 years of age are more prone to UTI 31/247 (12%).…”

mentioning

confidence: 87%

Study of Magnitude of Uti Caused by Esbl-Producing Escherichia Coli and Associated Risk Factors

CHATURVEDI

Gupta²,

CHATURVEDI³

et al. 2022

Asian J Pharm Clin Res

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Objective: Globally, urinary tract infections (UTIs) caused by Escherichia coli that produce extended-spectrum lactamase (ESBL) have become more common. Our study determined the magnitude of UTI occurring due to ESBL-producing E. coli and associated risk factors. Different methods for their phenotypic detection were also compared. Methods: Uropathogenic E. coli isolated in significant numbers were assayed microbiologically. E. coli isolates (n=247) that were found significant in number tested for ESBL production using three different phenotypic methods: Phenotypic combined disk diffusion test (PCDDT), double-disk approximation test (DDAT), and E-test for ESBL production. An antibiotic susceptibility test was performed for different antibiotics. Various risk factors associated with UTIs were correlated with ESBL- and non-ESBL-producing E. coli. Results: We found that diabetes mellitus type 2 was the most common risk factor for UTI caused due to ESBL-producing E. coli (25%). Pregnant females and patients having recurrent UTI showed less positivity for ESBL production. DDAT detected 32 ESBL-positive isolates and PCDDT detected 37 positive isolates. E-test was taken as the gold standard for ESBL detection which detected 49 isolates as ESBL producers. The highest sensitivity (71.2%) and specificity (75%) were shown by PCDDT. Conclusion: According to the study conducted, it was concluded that PCDDT was the most reliable and economic method for phenotypic detection of ESBL.

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“…Empirical antibacterial therapeutic approach depends on the severity of disease (e.g. uncomplicated vs. complicated UTIs), the spectrum of the possible pathogens and the local resistance patterns (8). The most frequent pathogens involved are from Enterobacteriaceae group, mainly E. coli and Klebsiella pneumonia (9).…”

Section: Introductionmentioning

confidence: 99%

Combination of cranberry extract and D-mannose�-�possible enhancer of uropathogen sensitivity to antibiotics in acute therapy of urinary tract infections: Results of a pilot study

et al. 2020

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Uncomplicated lower urinary tract infections are extremely common in women. Antibiotic treatment for acute episodes and for recurrence prophylaxis has its drawbacks and alternative therapies are sought in order to reduce the antimicrobial resistance phenomenon and the intestinal dismicrobism expansion. There are few studies on the effect of combination of cranberry extract with D-mannose in acute urinary tract infection management. In a pilot, randomized study 93 non-pregnant, otherwise healthy women, were enrolled with mean age of 39.77±10.36, diagnosed with uncomplicated lower urinary tract infection. Medical history, clinical examination, urine culture and a list of complaints were noted at the baseline visit. In a first phase of the study, treatment with either guideline recommended antibiotic alone or in association with the investigated product (cranberry extract plus D-mannose) was prescribed and all patients were clinically examined at day 7. All ameliorated and cured patients received in a second phase of the study, in a double-blind manner, prophylaxis with the investigated product or placebo for another 21 days, then a second clinical examination and a check of the list of complaints were performed. The cure rates were higher at day 7 when investigated product was added to antibiotic (91.6 vs. 84.4%). In resistant strains, a significantly higher cure rate was shown when the investigated product was added to antibiotic prescribed (88.8 vs. 37.5%, P<0.0001). The effect of cranberry extract plus D-mannose combination in acute urinary tract infection episodes seems to be promising. The significant cure rate registered in the patients with antibiotic-resistant urine cultures may be explained by a beneficial influence of the product on the antimicrobial sensitivity. Further studies are needed on this subject.

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Biochemical Changes and Risk Factors in the Prognosis of Antibiotics Susceptibility in Urinary Tract Infections

Cited by 5 publications

References 9 publications

The Impact of Urinary Catheterization on the Antibiotic Susceptibility of ESBL-Producing Enterobacterales: A Challenging Duo

The Impact of Urinary Catheterization on the Antibiotic Susceptibility of ESBL-Producing Enterobacterales: A Challenging Duo

Study of Magnitude of Uti Caused by Esbl-Producing Escherichia Coli and Associated Risk Factors

Combination of cranberry extract and D-mannose�-�possible enhancer of uropathogen sensitivity to antibiotics in acute therapy of urinary tract infections: Results of a pilot study

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