Multidrug-resistant community-acquired urinary tract infections in a northern region of Morocco: epidemiology and risk factors

Benaissa, Elmostafa; Belouad, Elmehdi; Mechal, Youness; Benlahlou, Yassine; Chadli, Mariama; Maleb, Adil; Elouennass, Mostafa

doi:10.18683/germs.2021.1291

Cited by 5 publications

(5 citation statements)

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“…The already established risk factors for the acquisition of an UTI caused by a drugresistant pathogen, as reported in numerous studies conducted worldwide [29][30][31] are age, male gender, previous hospitalizations, previous antibiotic use, and urinary catheterization, all of them being also significantly higher among patients with resistant isolates from our study, especially in the PDR and DTR groups. Furthermore, Faine et al identified some other risk factors, such as chronic hemodialysis and nursing home residence [32], while Ben Ayed et al found a correlation between the presence of diabetes mellitus or a history of urinary tract surgery in the last 12 months, with the acquisition of a MDR community-acquired UTI [33].…”

Section: Discussionsupporting

confidence: 69%

What Doesn’t Kill Them Makes Them Stronger: The Impact of the Resistance Patterns of Urinary Enterobacterales Isolates in Patients from a Tertiary Hospital in Eastern Europe

et al. 2022

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(1) Background: The evolution of bacterial resistance to antibiotics is one of the factors that make infectious pathology an extremely dynamic field, also inducing a significant burden on public health systems; therefore, continuous updates on the bacterial resistance to antibiotics and their particular regional patterns is crucial for the adequate approach of various infectious diseases. (2) Methods: We retrospectively analyzed 354 patients with Enterobacterales urinary tract infections (UTIs), determined their antibiotic resistance pattern, thus aiming to correlate them with the outcome and other specific markers of poor prognosis. (3) Results: The most frequent causative agent was Escherichia coli, representing 64.6% of all UTIs. We identified 154 patients resistant to multiple antibiotic classes, of which 126 were multidrug-resistant (MDR), 17 were extensive drug-resistant (XDR) and 11 were pandrug-resistant (PDR). Moreover, 25 isolates were resistant to carbapenems (CRE), 25 were difficult-to-treat (DTR), and 84 were extended-spectrum cephalosporin-resistant (ESC), with only 95 isolates susceptible to all tested antibiotics. Mortality ranged from 1% for UTIs caused by isolates susceptible to all tested antibiotics, to 24% for the ones caused by DTR or CRE isolates. Other significant risk factors associated with mortality were: prolonged hospital stay (p = 0.0001), Charlson comorbidity index ≥ 3 (p = 0.02), urinary catheterization (p = 0.001), associated respiratory pathologies (p = 0.004), obesity (p = 0.047), a history of previous hospitalizations (p = 0.007), inappropriate empiric antibiotic regimen (p = 0.001), or hyper inflammatory status (p = 0.006). Basically, we observed that a multiple regression model comprising urinary catheterization, inappropriate empiric anti-biotherapy, obesity, and respiratory comorbidities exhibits the best correlation with mortality rate in patients with UTI (R = 0.347, R2 = 0.12). (4) Conclusions: By focusing on the novel resistance patterns, our study provides complementary evidence concerning the resistance profiles found in an Eastern European region, as well as their prognostic implications in patients with UTI.

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Section: Discussionsupporting

confidence: 69%

What Doesn’t Kill Them Makes Them Stronger: The Impact of the Resistance Patterns of Urinary Enterobacterales Isolates in Patients from a Tertiary Hospital in Eastern Europe

et al. 2022

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“…Our study shows that 15.2% of urine samples contained strains of Staphylococcus spp. This rate remains close to the 16.97% found in a survey conducted in a provincial hospital in northern Morocco [ 32 ]. However, lower rates (4.2% to 8.13%) were reported in studies conducted in Rabat [ 33 ], in the city of Nouakchott [ 34 ], and in Dakar [ 35 ].…”

Section: Discussionsupporting

confidence: 86%

Antibiotic Resistance Profiling of Pathogenic Staphylococcus Species from Urinary Tract Infection Patients in Benin

Assouma,

Sina,

Dossou

et al. 2023

BioMed Research International

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Staphylococci can cause urinary tract infections (UTIs). These UTIs are among the significant causes of antibiotic resistance and the spread of antibiotic-resistant diseases. The current study is aimed at establishing a resistance profile and determining the pathogenicity of Staphylococcus strains isolated from UTI samples collected in Benin. For this purpose, urine samples (one hundred and seventy) that were collected from clinics and hospitals showed UTI in patients admitted/visited in Benin. The biochemical assay method was used to identify Staphylococcus spp., and the disk diffusion method tested the antimicrobial susceptibility. The biofilm formation ability of the isolates of Staphylococcus spp. was investigated by the colorimetric method. The presence of mecA, edinB, edinC, cna, bbp, and ebp genes was examined by multiplex polymerase chain reaction (PCR). The results showed that Staphylococcus species were identified in 15.29% of all infected individuals and that 58% of these strains formed biofilms. Most Staphylococcus strains (80.76%) were isolated in female samples, and the age group below 30 years appeared to be the most affected, with a rate of 50%. All Staphylococcus strains isolated were 100% resistant to penicillin and oxacillin. The lowest resistance rates were seen with ciprofloxacin (30.8%), gentamicin, and amikacin (26.90%). Amikacin was the best antibiotic against Staphylococcus strains isolated from UTIs. The isolates carried mecA (42.31%), bbp (19.23%), and ebp (26.92%) genes in varying proportions. This study provides new information on the risks posed to the population by the overuse of antibiotics. In addition, it will play an essential role in restoring people’s public health and controlling the spread of antibiotic resistance in urinary tract infections in Benin.

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“…Overall MAR index for Enterobacteriacae family persistently found to be high and alarmingly. This is indicating that there is rise in MDR organisms, comparable to many other studies 30,31,32 .…”

Section: (10%)supporting

confidence: 88%

“…While Morcoo based study reported higher rate of ESBL production in E. coli in their study. 31 ESBLproducers are considered to be posing more therapeutic inferences as these organisms show resistance against third generation cephalosporins, broad-spectrum ampicillin, and monobactams 33 .…”

Section: (10%)mentioning

confidence: 99%

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2024

IJPSR

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Introduction: Urinary tract infection is the most frequent infection reported worldwide till now. To better understanding regarding epidemiology and emerging antimicrobial resistance among bacterial uropathogens, we studied the demographic distribution and antibiotic susceptibility pattern of microorganisms causing UTI in our local hospital-based study. Materials and Methods: We analysed the retrospective data of laboratory confirmed UTIs, from January 2017 to December 2021. Causative agents of UTI, along with their demographic profile, distribution and their antibiogram was determined by using conventional methods. On the basis of that, 5-year multiple antibiotic resistance index was calculated to determine the resistance pattern of isolated bacterial uropathogens. Results: During study period, total 9426 samples were received. Out of which, 1133 (12.01%) showed significant bacteriuria with monomicrobial growth. With 64.17% isolation from female patients with predominance age group 16-60 years. From 1133 positive isolates, gram negative and gram positive isolates were reported in 298 (26.30%) and 835 (73.69%) isolates respectively, with predominance of E. coli (52.25%) followed by Enterococcus spp. (18.36%) Klebsiella spp. (8.21%). Multiple antibiotic resistance index over the 5 years study period found to be inconsistent and persistently high. Conclusion: The antimicrobial susceptibility data collected in our study suggest that antibiotic resistance is an emerging and common problem among bacterial uropathogens. This calls for routine and timely proper diagnosis of UTI along with its culture sensitivity results, that will help in definitive treatment rather than prescribing an empirical therapy. INTRODUCTION:Prescribing antibiotics empirically for Urinary tract infection (UTI) is a complex and imposes a great challenge for physician as well as for the patient under treatment 1 .

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Multidrug-resistant community-acquired urinary tract infections in a northern region of Morocco: epidemiology and risk factors

Cited by 5 publications

References 0 publications

What Doesn’t Kill Them Makes Them Stronger: The Impact of the Resistance Patterns of Urinary Enterobacterales Isolates in Patients from a Tertiary Hospital in Eastern Europe

What Doesn’t Kill Them Makes Them Stronger: The Impact of the Resistance Patterns of Urinary Enterobacterales Isolates in Patients from a Tertiary Hospital in Eastern Europe

Antibiotic Resistance Profiling of Pathogenic Staphylococcus Species from Urinary Tract Infection Patients in Benin

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