Species and Antimicrobial Resistance of Uropathogens Isolated from Patients with Urinary Catheter

Ko, Ming-Chung; Liu, Chih-Kuang; Woung, Lin‐Chung; Lee, Wen-Kai; Jeng, Huey-Sheng; Lu, Shing-Hwa; Chiang, Han-Sun; Li, Chung‐Yi

doi:10.1620/tjem.214.311

Cited by 20 publications

(16 citation statements)

References 25 publications

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“…However, in this study, members of the genus Klebsiella 35.7% were more commonly identified compared to E. coli 5.4%, an observation that has been documented in CAUTI elsewhere (Habte et al, 2009). Other researchers have also concluded that the frequency of isolation of E. coli as a causative agent of UTI is slowly declining and it is being replaced by other members of the enterobacteriaceae and enterococci (Ko et al, 2008;Teshager et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Urinary Pathogens and Their Antimicrobial Susceptibility in Patients with Indwelling Urinary Catheter

Onipede¹,

Oyekale²,

Olopade³

et al. 2010

Sierra Leone j. biomed. res.

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The indwelling urinary catheter (IUC) is the most significant risk factor for developing nosocomial urinary tract infections (UTIs). In order to determine the spectrum of bacterial etiology and antibiotic resistance pattern of uropathogens causing catheter associated UTI, a convenient sample size of ninety-two (92) patients on urethral catheter was investigated. Ethical approval for the study was obtained from the OAUTHC research and ethical committee. Catheter stream urine samples were obtained from all patients and cultured on appropriate culture media. Suspected isolates were identified by a combination of standard tests and using MICROBACT GNA12A/B/E. Susceptibility of the isolates against thirteen (13) antibiotics was performed by the disc diffusion method. Significant bacteriuria was observed in 60.9% (56) catheter specimen urine (CSU) received, while 39.1% (36) were culture negative. Of the 56 positive culture, the predominant organisms were Klebsiella oxytoca, 28.6 %( 16), Proteus vulgaris, 23.2% (13) and Staphylococcus aureus, 12.5% (7). Overall, the antimicrobial susceptibility results showed that all the isolates were highly resistant to the antibiotics tested. Over 50% resistance was recorded for trimethoprim/sulfamethoxazole, gentamicin and amoxicillin/clavulanic acid. More than 25% of the isolates were resistant to nitrofurantoin. This study indicates that catheter stream UTI caused by multiply resistant bacteria are common in our hospital. There is a need to establish standard guidelines on the care of catheter for all units in the hospital with a view to preventing nosocomial infections associated with the use of the catheter in patients. We also advocated prudent use of antibiotics. Key words: Antibiotic resistance, Urinary catheter, Uropathogens, Urinary tract infection Received 27 March 2010/ Accepted 1 June 2010 INTRODUCTIONUrinary tract infections (UTIs) are the most common infections found in the hospital as well as long-term care setting. The indwelling urinary catheter (IUC) is the most significant risk factor for developing catheter-associated urinary tract infections (CAUTIs). The risk of acquiring a urinary tract infection depends on the method and duration of catheterisation, the quality of catheter care, and host susceptibility among others. Several studies have indicated that between 75 and 80% of all healthcare associated UTIs follow the insertion of a urinary catheter (Bryan and

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Section: Discussionmentioning

confidence: 99%

Urinary Pathogens and Their Antimicrobial Susceptibility in Patients with Indwelling Urinary Catheter

Onipede¹,

Oyekale²,

Olopade³

et al. 2010

Sierra Leone j. biomed. res.

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“…14 They also found that patients with a urinary tract catheter had higher resistance rates (mean 51%) to cefazolin, TMP-SMX, ciprofloxacin, and gentamicin than patients without a urinary tract catheter for Enterobacteriaceae. 14 In 2009, the most common pathogen in nosocomial UTIs among 1992 patients admitted at National Taiwan University Hospital (NTUH) was Candida spp. (26.6%) followed by E. coli (18.8%), Enterococcus spp.…”

Section: Taiwanmentioning

confidence: 99%

Consensus review of the epidemiology and appropriate antimicrobial therapy of complicated urinary tract infections in Asia-Pacific region

Hsueh

Hoban

Carmeli

et al. 2011

Journal of Infection

124

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“…[5][6][7] Catheterization results in a higher prevalence of resistant organisms, including Pseudomonas species and rare gram-negative organisms. 9 In our patient, computed tomography of the abdomen and pelvis showed thickening of the cecum and terminal ileum with inflammatory stranding in the adjacent peritoneal fat. A fistulous communication was noted between a loop of terminal ileum and the dome of the urinary bladder.…”

Section: A History Of Whichmentioning

confidence: 50%

26-Year-Old Man With Recurrent Urinary Tract Infections

Seminerio

Aggarwal

Sweetser

2011

Mayo Clinic Proceedings

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A 26-year-old male college student presented with 1 week of constant, right lower quadrant, throbbing abdominal pain that was worse after eating and accompanied by bilious emesis. He had experienced similar, albeit less severe and self-limited, episodes of abdominal pain during the preceding 6 months. He denied fevers or chills but had lost 4.5 kg (10 lbs) in the past 6 months. During the same time period, he was treated twice with antibiotics for urinary tract infections (UTIs) after reporting symptoms of dysuria and noting "bubbles" in his urine. A urine culture was never obtained. Urinary tract infections are uncommon in men because of the longer length of the male urethra, antibacterial properties of prostatic fluid, and less frequent periurethral colonization in men. The incidence in men younger than 50 years is approximately 5 to 8 per 10,000 per year. The incidence of UTIs in men increases with age, and the lifetime prevalence is estimated at 13,000 to 14,000 per 100,000 adult men.1 Although most community-acquired UTIs in women can be treated empirically with antibiotics without the need for a urine culture, a urine culture should always be obtained when a male patient presents with a suspected UTI. Simple UTIs (eg, cystitis in women) can be treated with 3 days of antibiotics 2 ; however, UTIs in men are considered "complicated" by definition and warrant at least 7 days of antibiotic therapy. Dysuria is the most frequent presenting symptom of UTIs in both men and women. 1,3,4 Most UTIs are caused by gram-negative organisms from the colon that colonize the periurethral skin. E coli is the most common cause of UTIs in both sexes.On examination, the patient appeared pale and cachectic. Cervical, axillary, and inguinal lymph nodes were not palpable. His abdomen was scaphoid with marked right lower quadrant tenderness without rigidity, guarding, or rebound tenderness. An ill-defined mass was palpable in the right lower quadrant. There was no tenderness in the costovertebral angle. On auscultation, bowel sounds were normoactive. Laboratory studies yielded the following results (reference ranges provided parenthetically): hemoglobin concentration, 11.9 g/dL (13.5-17.5 g/dL); mean corpuscular volume, 78.3 fL (81.2-95.1 fL); white blood cell count, 15.9 × 10 9 /L (3.5-10.5 × 10 9 /L) with 85% neutrophils; and creatinine level, 1.1 mg/dL (0.9-1.4 mg/dL). Urinalysis revealed 21 to 30 white blood cells per high-powered field, 3 to 10 red blood cells per high-powered field, no casts, and numerous bacteria. A clean-catch, midstream urine specimen showed no bacterial growth. Urinary tract infections in men, especially if recurrent, warrant a search for an underlying structural abnormality, such as an enlarged prostate, colovesical fistulas associated with colonic malignancy or inflammatory bowel disease, and congenital malformations of the urogenital tract. Instrumentation of the urinary tract (eg, during a cystoscopy or catheterization) can result in UTIs in both men and women. Conditions that suppress immune function...

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Species and Antimicrobial Resistance of Uropathogens Isolated from Patients with Urinary Catheter

Cited by 20 publications

References 25 publications

Urinary Pathogens and Their Antimicrobial Susceptibility in Patients with Indwelling Urinary Catheter

Urinary Pathogens and Their Antimicrobial Susceptibility in Patients with Indwelling Urinary Catheter

Consensus review of the epidemiology and appropriate antimicrobial therapy of complicated urinary tract infections in Asia-Pacific region

26-Year-Old Man With Recurrent Urinary Tract Infections

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