Resistance Levels and Epidemiology of Non-Fermenting Gram-Negative Bacteria in Urinary Tract Infections of Inpatients and Outpatients (RENFUTI): A 10-Year Epidemiological Snapshot

Abstract

Background: Urinary tract infections (UTIs) are one of the most common infections in the human medicine, both among outpatients and inpatients. There is an increasing appreciation for the pathogenic role of non-fermenting Gram-negative bacteria (NFGNBs) in UTIs, particularly in the presence of underlying illnesses. Methods: The study was carried out using data regarding a 10-year period (2008–2017). The antimicrobial susceptibility testing was performed using the disk diffusion method, E-tests, and broth microdilution. Results: NFGNB represented 3.46% ± 0.93% for the outpatients, while 6.43% ± 0.81% of all positive urine samples for the inpatients (p < 0.001). In both groups, Pseudomonas spp. (78.7% compared to 85.1%) and Acinetobacter spp. (19.6% compared to 10.9%), were the most prevalent. The Acinetobacter resistance levels were significantly higher in inpatients isolates (p values ranging between 0.046 and <0.001), while the differences in the resistance levels of Pseudomonas was not as pronounced. The β-lactam-resistance levels were between 15–25% and 12–28% for the Acinetobacter and Pseudomonas spp., respectively. 4.71% of Acinetobacter and 1.67% of Pseudomonas were extensively drug resistant (XDR); no colistin-resistant isolates were recovered. Conclusions: Increasing resistance levels of the Acinetobacter spp. from 2013 onward, but not in the case of the Pseudomonas spp. Although rare, the drug resistant NFGNB in UTIs present a concerning therapeutic challenge to clinicians with few therapeutic options left.

<p>Molecular Characteristics and Antimicrobial Susceptibility Profiles of <em>Elizabethkingia</em> Clinical Isolates in Shanghai, China</p>

“…The genus Elizabethkingia is an infrequent Gram-negative non-fermenting bacillus and has recently emerged as a cause of life-threatening infections in humans, including meningitis, bacteremia, pneumonia and urinary tract infection. [1][2][3] Importantly, neonatal meningitis was the most common presentation of Elizabethkingia infection in children while a variety of clinical manifestations were reported in immunocompromised patients. 4 Furthermore, an increasing number of global cases of Elizabethkingia infection in recent years showed high morbidity and mortality, which reinforced the significance of early identification and treatment.…”

Prevalence of Escherichia Coli and Its Antimicrobial Susceptibility Profiles among Patients with UTI at Mulago Hospital, Kampala, Uganda

“…is ailment affects patients in all age groups and sexes, with females accounting for 87.5% of the cases compared with males (71.3%) [2][3][4]. is is associated with the short urethral tube of women and close proximity of the anus to the urethral opening, allowing easier access of the bacteria to the urethra.…”

Isolation and Antibiotic Resistance of Achromobacter xylosoxidans from Non-respiratory Tract Clinical Samples: A 10-year Retrospective Study in a Tertiary-care Hospital in Hungary

“…Although the relevance of this pathogen is emerging and its isolation and identification is becoming more frequent, little is known regarding the virulence characteristics of Achromobacter, especially the ones concerning its ability to adhere, colonize and subsequently cause infections in vivo [26,27]. The following virulence determinants have been identified in the genus: Flagella, lipopolysaccharide (LPS), other membrane-associated structures, phospholipase C, various proteases, cellulose, a type-3 secretion system (T3SS); these have all been noted to have roles in the inflammatory reaction caused by this bacteria in the airways, however, their roles in invasive infections are not yet understood [26][27][28]. In addition, the bacteria possess the ability to denitrify, thus, allowing for their persistence and survival in hypoxic or anaerobic environments [2][3][4].…”