Frequency and antibiotic susceptibility patterns of urinary pathogens  in male outpatients in Argentina

Villar, Hugo Edgardo; Jugo, Mónica Beatriz; Macan, Alejandro; Visser, Maaike; Hidalgo, Mariana; Maccallini, Gustavo

doi:10.3855/jidc.3766

Cited by 15 publications

(9 citation statements)

References 23 publications

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“…According to our results, not one agent could be declared fit for empiric use in elderly patients. Our findings are in accordance with numerous studies which also encountered high resistance rates among older age groups [24][25][26][27].…”

Section: Discussionsupporting

confidence: 82%

“…Guidelines state that if resistance to an antimicrobial agent exceeds the 20% threshold, it should no longer be recommended for empiric therapy [5,13,23]. Resistance rates among different age groups were observed to increase as the age of the patient increased, which supports claims from other studies [24][25][26][27]. Pathogens isolated from patients within the age group 18-34 years showed low rates of resistance to several antimicrobial agents (<10%), most notably to amikacin (4.2%), ceftriaxone (7.7%), cefepime (8.0%), and norfloxacin (10.0%), which implies that these agents should be used as firstline therapy for this age group in our population.…”

Section: Discussionsupporting

confidence: 78%

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Antimicrobial resistance in patients with urinary tract infections and the impact on empiric therapy in Serbia

Zec

Despotović²,

Spurnic-Radovanovic³

et al. 2016

J Infect Dev Ctries

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Introduction: Surveillance of antimicrobial resistance is essential in establishing treatment guidelines for urinary tract infections. The aim of this pilot study was to analyse resistance rates of pathogens, across different demographics and determine whether adjustments in empiric therapy should be considered for different age and gender groups. Methodology: A 5-year retrospective study included 256 patients hospitalised, under the initial diagnosis of Fever of Unknown Origin who were then subsequently diagnosed with a urinary tract infection at the Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia. Patients were evaluated using demographic, clinical, and antimicrobial resistance data with appropriate statistical analysis including ANOVA significance testing, univariate, and multivariate analysis. Results: Resistance rates were above the threshold of 20% for the majority of the antimicrobials tested, the only exception being carbapenems. Amikacin, cefepime, and norfloxacin were agents that could be effectively used as empiric therapy in younger adults with resistance rates of 4.2, 8.0, and 10.0%, respectively. Moderate resistance rates of 17.4% for amikacin and 19.1% for cefepime were observed in the age group 35-64 years. High resistance rates were observed for all antimicrobials among patients 65 years and over. Among male patients, resistance rates to most antimicrobials were high. In female patients, amikacin and cefepime had resistance rates less than 20%. Younger age presented as a negative risk factor for infection by a multi-drug resistant pathogen. Conclusion: Age and gender demonstrated to be significant factors for determining proper empiric therapy; large-scale studies from Serbia are needed to solidify these findings.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 78%

Antimicrobial resistance in patients with urinary tract infections and the impact on empiric therapy in Serbia

Zec

Despotović²,

Spurnic-Radovanovic³

et al. 2016

J Infect Dev Ctries

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“…Our findings for the fosfomycin MIC against E. coli and Klebsiella spp. were consistent with those reported in recent studies that evaluated in vitro susceptibility profiles (1,19,20). Fosfomycin presented high levels of activity against E. coli.…”

Section: Discussionsupporting

confidence: 81%

Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Fedrigo

Mazucheli

Albiero

et al. 2017

Antimicrob Agents Chemother

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Fosfomycin is widely used for the treatment of uncomplicated urinary tract infection (UTI), and it has recently been recommended that fosfomycin be used to treat infections caused by multidrug-resistant (MDR) Gram-negative bacilli. Whether urine acidification can improve bacterial susceptibility to fosfomycin oral dosing regimens has not been analyzed. The MIC of fosfomycin for 245 Gramnegative bacterial isolates, consisting of 158 Escherichia coli isolates and 87 Klebsiella isolates which were collected from patients with urinary tract infections, were determined at pH 6.0 and 7.0 using the agar dilution method. Monte Carlo simulation of the urinary fosfomycin area under the concentration-time curve (AUC) after a single oral dose of 3,000 mg fosfomycin and the MIC distribution were used to determine the probability of target attainment (PTA). Fosfomycin was effective against E. coli (MIC 90 Յ 16 g/ml) but not against Klebsiella spp. (MIC 90 Ͼ 512 g/ml). Acidification of the environment increased the susceptibility of 71% of the bacterial isolates and resulted in a statistically significant decrease in bacterial survival. The use of a regimen consisting of a single oral dose of fosfomycin against an E. coli isolate with an MIC of Յ64 mg/liter was able to achieve a PTA of Ն90% for a target pharmacodynamic index (AUC/MIC) of 23 in urine; PTA was not achieved when the MIC was higher than 64 mg/liter. The cumulative fractions of the bacterial responses (CFR) were 99% and 55% against E. coli and Klebsiella spp., respectively, based on simulated drug exposure in urine with an acidic pH of 6.0. A decrease of the pH from 7.0 to 6.0 improved the PTA and CFR of the target pharmacodynamic index in both E. coli and Klebsiella isolates.KEYWORDS Enterobacteriaceae, fosfomycin, Monte Carlo simulation, acidic pH, pharmacodynamics, urinary tract infection U rinary tract infections (UTIs) are the most common infections worldwide, and members of the family Enterobacteriaceae are the main pathogens responsible for UTIs (1). The rise in the rate of antibiotic resistance over the last several years has resulted in limited treatment options currently available for the treatment of infections caused by multidrug-resistant (MDR) bacteria. Fosfomycin is an old antibiotic agent frequently used to treat uncomplicated UTIs and has been reevaluated as a potential option for the treatment of infections caused by MDR Gram-negative bacteria (2). The dosage currently approved for the treatment of an uncomplicated UTI is a single

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“…Susceptibility to amikacin in our study was high as it was in studies carried out in other parts of the world [ 43 , 46 , 47 ]. However, the resistance to tetracycline in our study was 50% while in another study it was reported to be 26% [ 48 ].…”

Section: Discussionsupporting

confidence: 46%

“…No resistance to vancomycin, imipenem and doxycycline was observed among the studied isolates. In previous studies a high sensitivity to imipenem has been also reported [ 43 – 46 ]. These antibiotics seems to be a good choice for the treatment of UTI caused by E. coli but it should be considered that unlimited use of these antibiotics can gradually lead to increasing antibiotic resistant.…”

Section: Discussionmentioning

confidence: 67%

Antibiotic resistance, virulence factors and genotyping of Uropathogenic Escherichia coli strains

Raeispour

Ranjbar

2018

Antimicrob Resist Infect Control

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BackgroundThe way of treating different types of infectious diseases is really important. Using genotyping method, we can determine the genetic relatedness between the organisms with different resistance profile from different sources. The aim of this study was to determine antibiotic resistance and genotyping of uropathogenic Escherichia coli (UPEC) strains using pulsed field gel electrophoresis (PFGE).MethodEscherichia coli (E. coli) strains were recovered from the patients with urinary tract infections (UTI) whom admitted in several major hospitals in Tehran. Antibiotic susceptibility testing was done according to CLSI guideline. The present of some virulence factor have been detected using PCR assay. Genotyping of the strains was performed by PFGE and all PFGE profiles were subjected to data processing.ResultIn total, 60 E. coli strains were subjected to the study. Most of E. coli isolates were resistant to cefepime (100%) and cephalothin (74%) and susceptible to imipenem (100%), vancomycin (100%) and doxycycline (100%). Among the UPEC isolates the prevalence of fimbriae type I (fimH), hemolysin (hlyA) and aerobactin (aer) genes were 89%, 60% and 90%, respectively. The PFGE differentiated E. coli strains into 33 different genetic clusters. Majority (30%) of them including PFGE type 11 generated 15 bands, while PFGE type 2 was the lowest (2%) prevalent group with 9 bands.ConclusionThe result showed that the antibiotic resistance is escalating rapidly. UPEC strains causing infections are more likely to harbor certain virulence genes. Our finding also showed E. coli strains isolated under the study were belonged to the diverse clones.

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Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina

Cited by 15 publications

References 23 publications

Antimicrobial resistance in patients with urinary tract infections and the impact on empiric therapy in Serbia

Antimicrobial resistance in patients with urinary tract infections and the impact on empiric therapy in Serbia

Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Antibiotic resistance, virulence factors and genotyping of Uropathogenic Escherichia coli strains

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