Incidence of Urinary Tract Infection Among Patients: Systematic Review and Meta-Analysis

Mengistu, Dechasa Adare; Alemu, Addisu; Abdukadir, Abdi Amin; Husen, Ahmed Mohammed; Ahmed, Fila; Mohammed, Baredin

doi:10.1177/00469580231168746

Cited by 4 publications

(5 citation statements)

References 64 publications

(77 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With ~150 million cases/year globally [36], UTI refers to an infection anywhere along the upper or lower urinary tract, but uncomplicated cystitis [11] is a term reserved for the infected urothelium of the bladder (Figure 1). An estimated 25-40% primary care prescriptions of OAT are triggered by uncomplicated cystitis [46,47].…”

Section: Contribution Of Urinary Tract Infections (Utis) To Amrmentioning

confidence: 99%

“…Accordingly, this broad-based review focusses on the relevant published literature of the last two-to-three decades for describing the nuances of renal physiology [26,34,35] and pharmacokinetics relevant to understanding the strengths, weaknesses, opportunity, and threats (SWOT) of OAT in treatment successes and failures and recurrent infections [36]. The SWOT analysis of OAT is brought into sharper focus by the root cause analysis of the efficacy determinants-urine levels above the MIC at the first contact with uropathogens [37]to benchmark AMR associated with OAT [8,38,39] to AMR associated with intravesical antimicrobial therapy (IAT).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SWOT and Root Cause Analyses of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis

Tyagi,

Stewart

et al. 2024

Antibiotics

View full text Add to dashboard Cite

Nearly 150 million cases of urinary tract infections (UTIs) are reported each year, of which uncomplicated cystitis triggers > 25% of outpatient prescriptions of oral antimicrobial treatment (OAT). OAT aids immune cells infiltrating the urothelium in eliminating uropathogens capable of invading the urothelium and surviving hyperosmotic urine. This self-evident adaptability of uropathogens and the short interval between the introduction of Penicillin and the first report of antimicrobial resistance (AMR) implicate AMR as an evolutionary conserved heritable trait of mutant strains selected by the Darwinian principle to survive environmental threats through exponential proliferation. Therefore, AMR can only be countered by antimicrobial stewardship (AMS) following the principle of the five Ds—drug, dose, duration, drug route, and de-escalation. While convenient to administer, the onset of the minimum inhibitory concentration (MIC) for OAT in urine leaves a window of opportunity for uropathogens to survive the first contact with an antimicrobial and arm their descendant colonies with AMR for surviving subsequent higher urine antimicrobial levels. Meanwhile, the initial dose of intravesical antimicrobial treatment (IAT) may be well above the MIC. Therefore, the widespread clinical use of OAT for cystitis warrants an analysis of the strengths, weaknesses, opportunity, and threats (SWOTs) and a root cause analysis of the AMR associated with OAT and IAT.

show abstract

Section: Contribution Of Urinary Tract Infections (Utis) To Amrmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

SWOT and Root Cause Analyses of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis

Tyagi,

Stewart

et al. 2024

Antibiotics

View full text Add to dashboard Cite

show abstract

“…With ~150 million cases/year globally [13], UTI refers to infection anywhere along the upper or lower urinary tract, but cystitis is a term reserved for the infected urothelium of the bladder (Figure 1). An estimated 25-40% primary care prescriptions of OAT are triggered by uncomplicated cystitis [19].…”

Section: Contribution Of Urinary Tract Infection (Uti) To Amrmentioning

confidence: 99%

“…Microbes employ mechanisms of commensalism [10], mutualism, and parasitism to survive [11,12] hostile environments. This broad-based review is focused on the intrinsic deficiencies of oral antimicrobial treatments (OAT) in their perpetual battle with microbes infecting the bladder lining-urothelium, called uncomplicated cystitis, hereafter in this discussion [13]. The strengths, weaknesses, opportunity, and threat (SWOT) analysis of OAT for uncomplicated cystitis is complemented by a root cause analysis (RCA) of antimicrobial resistance (AMR) in cystitis [11,14,15] to shed light on the modest success of antimicrobial stewardship (AMS).…”

Section: Introductionmentioning

confidence: 99%

SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis

Tyagi,

Stewart

et al. 2024

Preprint

View full text Add to dashboard Cite

Out of a worldwide annual incidence of ~150 million cases for urinary tract infection (UTI), >25% of outpatient prescriptions of oral antimicrobial treatment (OAT) are for cystitis not complicated by sepsis. OAT aids the immune cells infiltrating urothelium to eliminate uropathogens attaching and invading urothelium amidst hyperosmotic urine. This adaptability of uropathogens and the short interval between Penicillin sale and the first antimicrobial resistance (AMR) report suggests that AMR is a 3.8 billion years old evolutionary conserved heritable trait of surviving environmental threats through exponential proliferation of mutant strains selected by Darwinian principle. Therefore, OAT success with minimal AMR can be ensured by antimicrobial stewardship (AMS) following the principle of 5Ds -drug, dose, duration, drug-route, and de-escalation. While convenient to administer, the onset of minimum inhibitory concentration (MIC) for OAT in urine is a window of opportunity for uropathogens to survive the first contact with OAT and the descendant colonies armed with AMR are likely to survive subsequent higher urine OAT levels. Meanwhile, intravesical antimicrobial treatment (IAT) delivers the first strike well above MIC. The root cause analysis of AMR dovetails with the strengths, weaknesses, opportunity, and threat (SWOT) analysis of OAT in this interdisciplinary review.

show abstract

“…Appropriate treatment of UTIs has become challenging due to high resistance to commonly prescribed antibiotics [ 1 ]. In the African region, UTIs were reported as a highly incident risk infectious disease [ 7 ]. Therefore, this study aimed to screen urine samples taken from UTI Egyptian non-hospitalized patients for positive cultures and describe antibiotic resistance profiles of the most common isolates.…”

Section: Introductionmentioning

confidence: 99%

Bacterial Diversity and Antibiotic Resistance Patterns of Community-Acquired Urinary Tract Infections in Mega Size Clinical Samples of Egyptian Patients: A Cross-Sectional Study

Tarek,

Abdalla,

Dokmak

et al. 2024

Cureus

View full text Add to dashboard Cite

Background: Community-acquired urinary tract infection (UTI) is one of the most common infectious diseases nowadays. Alarming increased levels of antimicrobial resistance are developing globally which limit treatment options and may lead to life-threatening problems. Aim: Our study aimed to collect surveillance data on non-hospitalized Egyptian UTI cases and to develop strategies against multidrug-resistant pathogens (MDR). According to our knowledge, this is the first study to screen this high number (15,252 urine samples) in a short period (three months), providing valuable data on resistance profiles in non-hospitalized Egyptian UTI patients. Methods: A total of 15,252 urine samples were collected from different patients. Positive cultures were identified using a semi-quantitative method. Kirby-Bauer's disc diffusion method was used for antibiotic susceptibility testing, the double disc diffusion method was used for extended-spectrum beta-lactamases-producing strains, and the Chi-square test was used for statistical data processing. Results: The results showed 61% positive cultures, females accounted for 67.5%. Infants and elderly patients showed the highest positive cultures (74.4% and 69.2%, respectively). Despite Escherichia coli being the most common uropathogen (47.19%), Klebsiella species(24.42%) were the most MDR and extended-spectrum β-lactamase (ESBL)-producing organisms. E. coli and Klebsiella spp. displayed increased resistance to cephalosporins (75% and 81%, respectively). In contrast, both organisms displayed high sensitivity to carbapenems. Unlike Klebsiella spp., E. coli was highly sensitive (92%) to first-line treatment (nitrofurantoin) for UTI. Moreover, trimethoprim/sulfamethoxazole showed higher sensitivity rates compared to other nations. Conclusion: Despite Escherichia coli being the most often identified bacteria in our isolates Klebsiella spp. displayed higher resistance to the majority of tested antibiotics. Fortunately, trimethoprim/sulfamethoxazole significantly increased sensitivity, especially against E. coli. However, both species showed high rates of cephalosporin resistance. Moreover, It is important to promote Egypt's national action plan for antimicrobial resistance in collaboration with the World Health Organization, especially in the community to minimize the chance of bacterial resistance in the Egyptian community.

show abstract

Incidence of Urinary Tract Infection Among Patients: Systematic Review and Meta-Analysis

Cited by 4 publications

References 64 publications

SWOT and Root Cause Analyses of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis

SWOT and Root Cause Analyses of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis

SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis

Bacterial Diversity and Antibiotic Resistance Patterns of Community-Acquired Urinary Tract Infections in Mega Size Clinical Samples of Egyptian Patients: A Cross-Sectional Study

Contact Info

Product

Resources

About