Flouroquinolones Resistant Escherichia Coli Isolated from Urine of Diabetics

Khan, Maria; Ikram, Aamer; Fatima, Zahra; Ahmed, Jawad; Ghafoor, Tariq; Lalani, Farida Khurram; Hassan, Shahzad

doi:10.29271/jcpsp.2019.12.1238

Cited by 6 publications

(9 citation statements)

References 4 publications

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“…In the present study, gram-negative bacteria were the most common uropathogen found in the samples (76.9%). These results are in agreement with those of previous studies in Pakistan, 38 , 39 Iran, 40 Ethiopia 11 and Canada. 41 Among the gram-negative uropathogens, Escherichia coli was the predominant bacterium isolated (48.8%).…”

Section: Discussionsupporting

confidence: 94%

Incidence Pattern, Antibiotic Susceptibility Pattern and Associated Risk Factors of Bacterial Uropathogens Among General Population of Pakistan

Khatoon,

Khanam,

Azam

et al. 2023

IDR

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Purpose Urinary tract infections (UTIs) are of the most common bacterial infections in Pakistan. Rapid increase in antibiotic resistance has resulted in a limited number of treatment options available. This study aimed to determine the incidence patterns of uropathogens, their antimicrobial susceptibility pattern and risk factors for UTI among the general population. Methods This laboratory-based cross-sectional study was conducted between November 2020 and March 2021. Urine samples were collected, cultured and bacterial isolates were identified. Bacterial isolates were tested for antimicrobial susceptibility. Data regarding socio-demographic characteristics, clinical features and risk factors were collected using structured questionnaire. Results Of 459 urine samples, 299 (65.1%) showed positive urine cultures (10 5 CFU/mL). Both gram-negative and gram-positive isolates were obtained, with a prevalence of 230 (76.9%) and 69 (23%), respectively. Escherichia coli was the predominant bacteria isolated 146 (48.8%), and it showed most susceptibility to cefoperazone and imipenem. Most of the gram-negative isolates were resistant towards ampicillin. Most risk factors were not significantly associated with UTI, except for age, income, and previous history of hospitalization. Conclusion UTI is an important problem in the study area, with a prevalence rate of 65%. All bacterial isolates developed resistance towards most antibiotics available on the market. Therefore, there is a need to develop management strategies based on susceptibility pattern of uropathogens. Additionally, proper public education regarding causes of disease transmission and control strategies is required.

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Section: Discussionsupporting

confidence: 94%

Incidence Pattern, Antibiotic Susceptibility Pattern and Associated Risk Factors of Bacterial Uropathogens Among General Population of Pakistan

Khatoon,

Khanam,

Azam

et al. 2023

IDR

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“…Lower levels of estrogen lead to a reduction of normal vaginal flors 22 . We observed that outdoor patients are more prone to get UTIs than indoor patients, this fact collaborates with another study by Khan et al 2014 23 . The community-acquired urinary tract is common compared to hospitalized, also following a study in Poland 24 .…”

Section: Discussionsupporting

confidence: 93%

Fosfomycin Resistance in Clinical Isolates of Escherichia coli from Urinary Tract Infections in a Tertiary Care Hospital

2023

PJMD

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Background: Fosfomycin is called an old-new antibiotic, because it was reintroduced for the treatment of urinary tract infections. The rampant use of antibiotics has led to Fosfomycin resistance reported from different parts of the world. The purpose of this study was to find out the frequency of Fosfomycin resistance in clinical isolates of Escherichia coli (E. coli) from urinary tract samples. Methods: This cross-sectional study, including n=314 patients, was conducted in the Microbiology laboratory at Pakistan Naval Ship SHIFA Hospital, Pakistan from January to June 2022. Urine samples were inoculated on agar at 37±2°C for 24-48hrs. The growth of E. coli was confirmed by API 10S as per recommended Clinical Laboratory Standard Institute (CLSI) guidelines. Susceptibility testing was performed by the standard Kirby Bauer Disc Diffusion method. The Chi-square test was applied to categorical variables. p-value ≤ 0.05 was considered statistically significant. Results: Out of 314 clinical isolates, 171 (54.5%) were females and 143 (45.5%) were males (mean age 49±10.3 (6-81) years). Sixty-six (21%) isolates were found resistant to Fosfomycin while 248 (79%) were sensitive. A significant difference was found between the gender (p=0.035), whereas, 29 (17.0%) females and 37 (25.9%) males were found resistant to Fosfomycin. Conclusion: The resistance to Fosfomycin is increasing and it is an impending threat as oral treatment options are limited in urinary tract infections. However, improved surveillance may help in controlling nosocomial infection along with the rational use of antibiotics can prevent and reduce its spread. Keywords: Fosfomycin; Culture; Susceptibility; Urinary Tract Infections (UTIs).

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“…However, it is particularly alarming from the viewpoint of UTI treatment that diabetic individuals are at >2-fold higher risk of UTI by drug-resistant uropathogens. For example, (i) a study from Singapore noted a significant increase in the susceptibility of diabetic individuals to uropathogens from amoxicillin-clavulanate resistant Enterobacteriaceae family with adjusted OR (aOR) of 2.54 ( P = 0.03) [ 48 ]; (ii) 85.2% UPEC isolated from diabetic patients with UTI were multidrug resistant ( N = 1520; mean age = 58 years) in a study from Pakistan [ 49 ]; (iii) DM increased susceptibility to UTI by multidrug resistant bacteria (OR = 2.05; P = 0.001) in kidney transplant recipients from Brazil [ 50 ]; (iv) DM increased risk of UTI caused by extended spectrum cephalosporin-resistant Enterobacteriaceae (OR = 2.7, P = 0.007) in a study from the US [ 51 ]; (v) DM increased the risk of UTI by extended spectrum β -lactamase (ESBL) producing E. coli and K. pneumoniae with OR (adjusted for age and sex) = 5.51 ( P = 0.036) in a study from the UK [ 52 ], with OR = 4.4 ( P = 0.002) in a study from the US [ 53 ], adjusted OR = 3.2 ( P = 0.051) in a study from Norway [ 54 ], and OR calc = 1.96 ( P = 0.032) in a study from Spain [ 55 ]; (vi) diabetes increases the risk of UTI by uropathogens resistant to quinolone antibiotics with OR = 3.5 ( P < 0.01) in a study from Taiwan [ 56 ] and OR = 2.09 ( P = 0.04) in a study from France and to cephalosporins with an OR = 3.67 ( P = 0.05) [ 42 ]; (vii) in a cohort of patients with E. coli UTI (DM = 190; no DM = 81), significantly higher number of diabetics (90%) compared to nondiabetic controls (67.2%) were infected with strains resistant to one or more cephalosporins [ 57 ]; and (viii) in renal transplant recipients with K. pneumoniae bacteriuria ( N = 100), DM increased the risk of carbapenem-resistant Kp bacteriuria (aOR = 5.5; P = 0.01) which is in turn associated with graft failure and mortality [ 58 ].…”

Section: The Etiology Of Urinary Colonization In Diabetesmentioning

confidence: 99%

Systematic Review of Literature Examining Bacterial Urinary Tract Infections in Diabetes

Paudel

John

Poorbaghi

et al. 2022

Journal of Diabetes Research

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This systematic review addresses the central research question, “what is known from the published, peer-reviewed literature about the impact of diabetes on the risk of bacterial urinary tract infections (UTI)?” We examine the results from laboratory studies where researchers have successfully adapted mouse models of diabetes to study the pathophysiology of ascending UTI. These studies have identified molecular and cellular effectors shaping immune defenses against infection of the diabetic urinary tract. In addition, we present evidence from clinical studies that in addition to diabetes, female gender, increased age, and diabetes-associated hyperglycemia, glycosuria, and immune impairment are important risk factors which further increase the risk of UTI in diabetic individuals. Clinical studies also show that the uropathogenic genera causing UTI are largely similar between diabetic and nondiabetic individuals, although diabetes significantly increases risk of UTI by drug-resistant uropathogenic bacteria.

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Flouroquinolones Resistant Escherichia Coli Isolated from Urine of Diabetics

Cited by 6 publications

References 4 publications

Incidence Pattern, Antibiotic Susceptibility Pattern and Associated Risk Factors of Bacterial Uropathogens Among General Population of Pakistan

Incidence Pattern, Antibiotic Susceptibility Pattern and Associated Risk Factors of Bacterial Uropathogens Among General Population of Pakistan

Fosfomycin Resistance in Clinical Isolates of Escherichia coli from Urinary Tract Infections in a Tertiary Care Hospital

Systematic Review of Literature Examining Bacterial Urinary Tract Infections in Diabetes

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