Urinary tract infection pathogens and antimicrobial susceptibilities in Kobe, Japan and Taipei, Taiwan: an international analysis

Chiang, Yi-Te; Shigemura, Katsumi; Nishimoto, Kento; Yamada, Naoki; Kitagawa, Koichi; Sung, Shian Ying; Chen, Kuan Chou; Fujisawa, Masato

doi:10.1177/0300060519867826

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…There were several bacterial characteristics contributing to the development of E. coli UTI, the phylogenicity, virulence factors, and antimicrobial resistance of UPEC strains varied from region to region [ 14 – 19 ]. The study dealing with uncomplicated community-acquired UTI in women by PFGE showed that 77% after Pivmecillinam treatment had a relapse with the primary infecting E. coli strains [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Characterization of host and escherichia coli strains causing recurrent urinary tract infections based on molecular typing

et al. 2023

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Background Escherichia coli is the leading pathogen responsible for urinary tract infection (UTI) and recurrent UTI (RUTI). Few studies have dealt with the characterization of host and bacteria in RUTI caused by E. coli with genetically identical or different strains. This study aimed to investigate the host and bacterial characteristics of E. coli RUTI based on molecular typing. Results Patients aged 20 years or above who presented with symptoms of UTI in emergency department or outpatient clinics between August 2009 and December 2010 were enrolled. RUTI was defined as patients had 2 or more infections in 6 months or 3 or more in 12 months during the study period. Host factors (including age, gender, anatomical/functional defect, and immune dysfunction) and bacterial factors (including phylogenicity, virulence genes, and antimicrobial resistance) were included for analysis. There were 41 patients (41%) with 91 episodes of E. coli RUTI with highly related PFGE (HRPFGE) pattern (pattern similarity > 85%) and 58 (59%) patients with 137 episodes of E. coli RUTI with different molecular typing (DMT) pattern, respectively. There was a higher prevalence of phylogenetic group B2 and neuA and usp genes in HRPFGE group if the first episode of RUTI caused by HRPFGE E. coli strains and all episodes of RUTI caused by DMT E. coli strains were included for comparison. The uropathogenic E. coli (UPEC) strains in RUTI were more virulent in female gender, age < 20 years, neither anatomical/ functional defect nor immune dysfunction, and phylogenetic group B2. There were correlations among prior antibiotic therapy within 3 months and subsequent antimicrobial resistance in HRPFGE E. coli RUTI. The use of fluoroquinolones was more likely associated with subsequent antimicrobial resistance in most types of antibiotics. Conclusions This study demonstrated that the uropathogens in RUTI were more virulent in genetically highly-related E. coli strains. Higher bacterial virulence in young age group (< 20 years) and patients with neither anatomical/functional defect nor immune dysfunction suggests that virulent UPEC strains are needed for the development of RUTI in healthy populations. Prior antibiotic therapy, especially the fluoroquinolones, within 3 months could induce subsequent antimicrobial resistance in genetically highly-related E. coli RUTI.

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Section: Discussionmentioning

confidence: 99%

Characterization of host and escherichia coli strains causing recurrent urinary tract infections based on molecular typing

et al. 2023

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“…UTIs are the most common class of infectious disease, and antibiotics are their main means of treatment. The most common pathogen group in urine cultures is PE, which accounts for 30% to 40% of all urine culture bacteria [9]. In recent years, ESBL-PE infection has been on the rise, and it is the main cause of hospital and community-acquired infections.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, ESBL-PE infection has been on the rise, and it is the main cause of hospital and community-acquired infections. In a study of antimicrobial resistance trends from 2010 to 2013, ESBL-PE was frequently detected in China and Southeast Asia, and the ESBL production rate of E. coli and K. pneumoniae in some Asian countries was as high as 60% [9]. A study by Vachvanichsanong estimated that ESBL-PE represented one-third of all E. coli and K. pneumoniae UTI episodes [11].…”

Section: Discussionmentioning

confidence: 99%

A Clinical Prediction Tool for Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Urinary Tract Infection

Liu

Qiu

Chen

et al. 2021

Preprint

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Background To explore the risk factors of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) infection through urine samples of hospitalized patients and establish a predictive model to improve treatment outcomes.MethodsThis retrospective study included all patients with an Enterobacteriaceae-positive urine sample at the first affiliated hospital of Jinan university from January 2018 to December 2019. Antimicrobial susceptibility patterns of ESBL-PE were analyzed, and multivariate analysis of related factors was performed. From these, a nomogram was established to predict the possibility of ESBL-PE infection. Simultaneously, susceptibility testing of a broad array of carbapenem antibiotics was performed on ESBL-PE cultures to explore possible alternative treatment options.ResultsOf the total 874 patients with urinary tract infections (UTIs), 272 (31.1%) were ESBL-PE positive. In the predictive analysis, five variables were identified as independent risk factors for ESBL-PE infection: male gender (OR=1.607, 95% CI 1.066-2.416), older age (OR=4.100, 95% CI 1.678-12.343), a hospital stay in preceding 3 months (OR=1.872, 95% CI 1.141-3.067), invasive urological procedure (OR=1.810, 95% CI 1.197-2.729), and antibiotic use within the previous 3 months (OR 0.546, 95% CI 0.314-0.948). In multivariate analysis, the data set was divided into a training set of 611 patients and a validation set of 263 patients The model developed to predict ESBL-PE infection was effective, with the AuROC of 0.650 (95% CI 0.577-0.725). Among the antibiotics tested, several showed very high effectiveness against ESBL-PE: amikacin (85.7%), carbapenems (83.8%), tigecycline (97.1%) and polymyxin (98.2%). ConclusionsThe nomogram is useful for estimating a bacteremic patient’s likelihood of infection with ESBL-PE. It could improve clinical decision making and enable more efficient empirical treatment. Empirical treatment may be informed by the results of the antibiotic susceptibility testing.

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“…Staphylococcus aureus, Streptococcus pyogenes, and Enterococcus faecalis are microbes most frequently isolated from wound infections [24]. Same pathogens Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis are prevailing in postpartum UTIs [25]. Escherichia coli, Klebsiella pneumoniae, and Streptococcus are the most frequently isolated pathogens in postpartum sepsis [26].…”

Section: Puerperal and Postpartum Infection Microbiologymentioning

confidence: 99%

Evaluation of Puerperal and Postpartum Infections after Cesarean Section and Their Clinical Outcomes

Feruza,

Wang

2023

OJIM

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Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portion of the global healthcare burden. Puerperal sepsis is one of the top five causes of maternal deaths worldwide and accounts for 10% -15% of deaths in the postpartum period. Postpartum infections also present a significant social burden: they increase maternal anxiety and the risk of postpartum depression, interfere with bonding, and negatively impact breastfeeding. To prevent complications and improve outcomes, the evaluation of these infections must be accurate and prompt. This review provided a summary of causes, clinical presentation, laboratory tests, imaging modalities, treatment options, complications, and prognosis of puerperal and postpartum infections following cesarean section. Future directions in the evaluation of these infections were also discussed, including the development of novel diagnostic assays, the use of point-of-care testing and risk factors responsible for the onset of infections. This review emphasized the significance of early diagnosis and prompted treatment of these infections in order to prevent complications and enhance maternal and neonatal outcomes. This article also provided an exhaustive overview of the evaluation and management of puerperal and postpartum infections and the clinical outcome of infections for both mother and neonate.

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Urinary tract infection pathogens and antimicrobial susceptibilities in Kobe, Japan and Taipei, Taiwan: an international analysis

Cited by 9 publications

References 24 publications

Characterization of host and escherichia coli strains causing recurrent urinary tract infections based on molecular typing

Characterization of host and escherichia coli strains causing recurrent urinary tract infections based on molecular typing

A Clinical Prediction Tool for Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Urinary Tract Infection

Evaluation of Puerperal and Postpartum Infections after Cesarean Section and Their Clinical Outcomes

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