Urinary Tract Infection due to Extended-Spectrum Beta-Lactamase Producing Organisms is a Risk Factor for Acute Kidney Injury among Patients with Type 2 Diabetes Mellitus

Rahim, Muhammad Abdur; Mitra, Palash; Haque, Ariful; Zaman, Shahana; Samad, Tabassum; Haque, Wasim Md Mohosin Ul; Ananna, Meheruba Alam; Chowdhury, Tufayel Ahmed; Saha, Shudhanshu Kumar; Sarker, Shyamal; Iqbal, Sarwar; Mansur, Mohammad Abul

doi:10.3329/jom.v19i1.34840

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…This study was in accordance with findings by Selim et al (2019)19 from Egypt who detected bacterial growth in 100% of urine samples from patients with +4 glucosuria level. Mono microbial etiology of UTIs was found to be more common in this study, where E.coli was the most prevalent organism (58.4%); similar findings had been reported by Zubair et al (2019) 14 from Pakistan and Rahim et al 20 from Bangladesh. Out of 103 UTIs caused by E.coli and K. pneumoniae , 25 (24.3%) were due to ESBLs producing isolates.…”

Section: Discussionsupporting

confidence: 91%

“…In the present study, ESBLs production appeared as a significant risk factor for acute kidney injury, where all patients with history of AKI had ESBL-UTIs (100%). Same finding were reported by Rahim et al (2018) from Bangladesh 20 and Ramadas et al (2014) from New York 28 . The results of antimicrobial susceptibility revealed that E. coli showed high resistance percentages to ampicillin (78.8%), followed by cefaclor (63.6%), norfloxacin (57.6%) and nitrofurantoin (54.6%).…”

Section: Discussionsupporting

confidence: 83%

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Phenotypic and genotypic detection of extended spectrum β-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from type 2 diabetic patients with urinary tract infections

Elmi¹,

Ashour²,

Alsewy³

et al. 2021

Afr H. Sci.

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Background: T2DM patients are more likely to have UTIs caused by resistant organisms such as ESBLs producing bacteria. Challenging reliable identification and prompt characterization of in-vitro susceptibilities of these bacteria are the first steps of deciding the appropriate antimicrobial therapy for UTIs caused by them. Objectives: To isolate and identify E. coli and K. pneumoniae from urine of T2DM patients with UTIs, to determine antibiotic resistance pattern among isolates, and to identify ESBLs production phenotypically and genotypically. Material and method: All samples were cultured on Cystine-Lactose-Electrolyte-Deficient Agar medium (CLED) by using calibrated loop. Growth of 100 colonies or more, i.e. 105 colony forming units (CFU)/mL urine was considered as signifi- cant bacteriuria. Isolation and identification were done according to standard method. All isolates were tested for antibiotic susceptibility testing by the disc diffusion method according to CLSI guidelines. Phenotypic detection of ESBLs was done by double-disk synergy test. Genotypic detection of blaTEM, blaSHV and blaCTX-M genes by using PCR. Results: Results of this study showed that E. coli and K. pneumoniae were the dominant bacterial isolates, they constituted 103 (91.2%) out of 113 urine isolates. E. coli (58. 4%) K. pneumoniae (32.7%), Enterococcus spp. (4.4%), Proteus spp. (2.7%) and Pseu- domonas spp. (1.8%). About 25 (24.3%) out of 103 E. coli and K. pneumoniae isolates were ESBLs positive by DDST, and 22 (88.0%) out of them had ESBLs encoding genes by conventional PCR. The most common gene detected was blaTEM (59.1%), followed by blaSHV (27.3%). CTX-M had not been detected in any of testes isolates. Conclusion: blaTEM and blaSHV genes were detected in 22 out of 25 ESBLs producing E. coli and K. pneumoniae isolates phenotypically detected by DDST. blaTEM was found to be the predominant gene (59.1%), while blaCTX-Mene was not detected in any of tested isolates. Keywords: Extended Spectrum β-Lactamases; Type 2 diabetes mellitus; Urinary tract infections; Phenotypic; genotypic methods.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Phenotypic and genotypic detection of extended spectrum β-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from type 2 diabetic patients with urinary tract infections

Elmi¹,

Ashour²,

Alsewy³

et al. 2021

Afr H. Sci.

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“…In 2016, for example, Al Yousef et al,26 isolated 296 ESBL samples and found that diabetes was a risk factor associated with ESBL infection. In addition, Rahim et al,27 found that diabetes was significantly linked to ESBL infection. The current study reveals that diabetes is significantly associated with ESBL infection ( p =0.02).…”

Section: Discussionmentioning

confidence: 99%

Risk factors and molecular features of extended-spectrum beta-lactamase producing bacteria at southwest of Saudi Arabia

Al-Garni

Ghonaim

Ahmed

et al. 2018

SMJ

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Objectives:To explore the risk factors, the prevalence rate, and gene types of extended-spectrum beta-lactamase (ESBL)-producing bacteria as the causative agents of infection at King Abdulaziz Specialist Hospital (KAASH), Taif, Kingdom of Saudi Arabia.Methods:This was a retrospective study conducted during the period between February 2017 and January 2018. All samples obtained from the KAASH were analyzed. The MicroScan Walkaway System, bacteriological examination and double disk synergy tests were used to detect ESBL-producing bacteria. To identify ESBL genes, the polymerase chain reaction (PCR) technique was used.Results:The ESBL phenotype was detected in 351 of 1151 isolates (30.5%); Escherichia coli (E. coli) (62.7%) and Klebsiella pneumoniae (K. pneumoniae) (23.6%) were the most prevalent. The highest proportion of ESBL specimens was found in urine (62%.5), and these organisms were mainly isolated from the female medical ward (20.2%). Based on the statistical analysis, lung diseases, renal diseases, diabetes and heart diseases contributed to the spread of ESBL infections. Amikacin, imipenem, meropenem and tigecycline were found to be effective in overcoming ESBL infections; however, these antibiotics may be inappropriate for new strains of K.pneumoniae. The distribution of the blaCTX-M gene was high (87%), compared with blaTEM (74.9%) and blaSHV (29.4%).Conclusion:These data provide new epidemiological information about the prevalence of ESBL-producing organisms among patients in KAASH, Taif, Saudi Arabia. In addition, this study identified the clonal nature of isolated E.coli and K.pneumoniae.

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“…5 Almost half of T2DM develop ESBL-positive UTIs that might result in acute kidney injury. 6 C-reactive protein (CRP) has been used as an early biomarker predicting bacterial infections and is used as a marker to monitor antibiotic treatment of these infections. 7 Recent reports have suggested the use of CRP blood levels to differentiate acute pyelonephritis (upper UTIs) from asymptomatic bacteriuria in pediatric UTIs.…”

Section: Introductionmentioning

confidence: 99%

<p>Blood Neutrophil-to-Lymphocyte Ratio and Urine IL-8 Levels Predict the Type of Bacterial Urinary Tract Infection in Type 2 Diabetes Mellitus Patients</p>

Sharif-Askari¹,

Sharif-Askari²,

Guella³

et al. 2020

IDR

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Background: Extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are the most common uropathogens causing UTI (urinary tract infection) in type 2 diabetes mellitus (T2DM). Circulatory inflammatory markers such as C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) are usually dysregulated during UTI. However, the differential regulation of these inflammatory signatures during E. coli and K. pneumoniae UTI in T2DM has not been determined. Methods: A case-control study on 466 patients was performed to investigate the inflammatory signatures indicative of ESBL-E. coli and K. pneumoniae UTIs in T2DM. Serum CRP levels and blood NLR for these patients were determined and associated with E. coli and K. pneumoniae ESBL uropathogen using multivariate logistic regression analysis. Urinary interleukin 8 (IL-8) levels were also assessed and associated with these two UTI uropathogens in T2DM. The association of the two ESBL-uropathogens with the survival outcomes of T2DM patients was also analyzed using Cox-proportional hazard model. Results: T2DM patients with ESBL-E. coli UTI had lower serum CRP levels (median, CRP mg/dL 33.7 vs 39.8, respectively; P=0.023) and higher blood NLR (median, NLR 3.2 vs 2.6, respectively; P=0.010) compared to those with K. pneumoniae UTIs (P<0.001). Moreover, in T2DM, the urinary IL-8 levels was higher in ESBL-E. coli compared to those with K. pneumoniae UTIs (P<0.0001). After adjusting for confounders, including age, gender, serum albumin, hemoglobulin, leukocytes, and platelet counts, T2DM patients with blood NLR ≥ 3.5 were at higher risk for ESBL-E. coli UTIs than ESBL-K. pneumoniae UTIs (odds ratio [OR], 3.61, 95% confidence interval, Cl, 1.49-8.73; P=0.004). Moreover, T2DM patients with ESBL-E. coli UTIs had higher all-cause mortality (hazard ratio [HR], 4.09; 95%, 1.14-14.59) than those with K. pneumoniae UTIs. Conclusion: Serum CRP levels, blood NLR, and IL-8 urinary levels differentiate ESBL-E. coli from K. pneumoniae UTIs in T2DM.

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Urinary Tract Infection due to Extended-Spectrum Beta-Lactamase Producing Organisms is a Risk Factor for Acute Kidney Injury among Patients with Type 2 Diabetes Mellitus

Cited by 4 publications

References 13 publications

Phenotypic and genotypic detection of extended spectrum β-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from type 2 diabetic patients with urinary tract infections

Phenotypic and genotypic detection of extended spectrum β-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from type 2 diabetic patients with urinary tract infections

Risk factors and molecular features of extended-spectrum beta-lactamase producing bacteria at southwest of Saudi Arabia

<p>Blood Neutrophil-to-Lymphocyte Ratio and Urine IL-8 Levels Predict the Type of Bacterial Urinary Tract Infection in Type 2 Diabetes Mellitus Patients</p>

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