2,254 results on '"nitrofurantoin"'
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2. Patent Issued for Combination comprising zidovudine and an antimicrobial compound (USPTO 11951119).
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AZIDOTHYMIDINE ,URINARY tract infections ,NUCLEOSIDE reverse transcriptase inhibitors ,GRAM-negative bacterial diseases ,NITROFURANTOIN - Abstract
A patent has been issued for a combination of the antiretroviral drug zidovudine and certain urinary tract antibiotics, including nitrofurantoin, mecillinam, fosfomycin, cephalexin, and faropenem. The combination has been found to have a greater biological activity than expected when used at the stated dosage level. This is significant in the fight against antimicrobial resistance, particularly in the treatment of urinary tract infections. The patent provides compositions and methods for treating microbial infections, particularly bacterial infections, using this combination. [Extracted from the article]
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- 2024
3. Geographic Variations in Pharmacy Services and Availability of Commonly Prescribed Pediatric Urology Medications: An Opportunity to Improve Health Equity in Washington State
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Kathleen Kieran and Jorge A. Whitley
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Washington ,medicine.medical_specialty ,Health Equity ,business.industry ,Urology ,Pharmacy ,Community Pharmacy Services ,Health Services Accessibility ,Pediatric urology ,Health equity ,Nitrofurantoin ,Hydrocodone ,Emergency medicine ,medicine ,Humans ,Medical prescription ,Child ,business ,Prescribed medications ,medicine.drug - Abstract
OBJECTIVE To describe geographic and sociodemographic variations in operating hours and availability of medications commonly prescribed by pediatric urologists at Washington State retail pharmacies. METHODS We identified all retail pharmacies in the state. We stratified counties by population density and household income (HI) and compared differences in pharmacy operating hours and availability of 10 commonly prescribed medications. RESULTS 1057/1058 pharmacies were contacted. All pharmacies had liquid formulations of oxycodone, hydrocodone, ibuprofen, acetaminophen, amoxicillin, and trimethoprim-sulfamethoxazole in stock. Liquid formulations of ciprofloxacin (10%) and oxybutynin (14.3%) were uncommonly stocked, while 92.5% of pharmacies stocked nitrofurantoin suspension and 80.9% nitrofurantoin capsules. Statewide, 108 (10.2%) of pharmacies were closed on Saturdays and 297 (28.1%) closed on Sunday. More high (HPDC) than low population density (LPDC) (62.5% vs 0%, p
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- 2022
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4. Antibiotic susceptibility and fosfomycin resistance characterization in a cohort of children older than 6 years of age with urinary tract infection
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Luciana Robino, Leticia Caiata, Virginia García-Fulgueiras, Inés Bado, and Gustavo Giachetto
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Microbiology (medical) ,medicine.drug_class ,Antibiotic sensitivity ,Antibiotics ,Microbial Sensitivity Tests ,Urine ,Fosfomycin resistance ,Fosfomycin ,fosA3 ,medicine.disease_cause ,Infección urinaria ,Microbiology ,beta-Lactamases ,03 medical and health sciences ,Drug Resistance, Bacterial ,Escherichia coli ,Humans ,Medicine ,Child ,Children ,Niños ,Escherichia coli Infections ,Phylogeny ,Urinary tract infection ,0303 health sciences ,030306 microbiology ,business.industry ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,Anti-Bacterial Agents ,Nitrofurantoin ,Urinary Tract Infections ,Resistencia a fosfomicina ,Ceftriaxone ,business ,Cefuroxime ,medicine.drug - Abstract
Fosfomycin tromethamol (FT) was reintroduced as an option for the treatment of low urinary tract infection (UTI) in children. In this study, we described the antibiotic sensitivity and mechanisms of resistance to fosfomycin in isolates from children older than 6 years with UTI. Urine culture and antibiotic susceptibility study were performed. In fosfomycin resistant strains, PCR for fos, blaCTX-M was performed followed by classification by phylogenetic group and sequencetyping. Escherichia coli was the most frequent etiological agent (89.2%). The susceptibility percentages were: fosfomycin 97.9%; amoxicillin-clavulanate 92.7%; cefuroxime and ceftriaxone 99%; nitrofurantoin 94.4%. An E. coli strain (ST69, phylogenetic group D) was resistant to fosfomycin (MIC 256mg/l) and carried the blaCTX-M-14 and fosA3 genes in a 45kb IncN-type plasmid. Resumen La fosfomicina-trometamol (FT) se reintrodujo como una opción para el tratamiento de la infección del tracto urinario (ITU) baja en niños. En este estudio describimos la sensibilidad antibiótica y los mecanismos de resistencia a FT en aislamientos de niños mayores de 6 anos con ITU. Se realizaron urocultivos y estudios de sensibilidad antibiótica. En las cepas resistentes a fosfomicina se realizó la técnica de PCR para fos, blaCTX-M, y su identificación según su grupo filogenéticoy secuenciotipo. Escherichiacoli fue el agente etiológico más frecuente (89,2%). Los porcentajes de sensibilidad fueron: fosfomicina 97,9%; amoxicilina-clavulánico 92,7%; cefurox-ima y ceftriaxona 99%; nitrofurantoína 94,9%. Una cepa de E. coli (ST69, grupo filogenético D) fue resistente a fosfomicina (CIM 256mg/l) y portaba los genes blaCTX-M-14 y fosA3 en un plás-mido de 45 kb del tipo IncN. Este es el primer reporte de E. coli ST69 con blaCTX-M-14/fosA3 de origen humano.
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- 2022
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5. Five versus seven days of nitrofurantoin for urinary tract infections in women with diabetes: a retrospective cohort study
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Theo J M Verheij, Cornelis H. van Werkhoven, Kelly D. Hendriks-Spoor, Thijs ten Doesschate, Julia W. Dorigo-Zetsma, and Floor L. Wille
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Microbiology (medical) ,medicine.medical_specialty ,business.industry ,Urinary system ,Significant difference ,Anti-Infective Agents, Urinary ,Retrospective cohort study ,General Medicine ,medicine.disease ,Treatment failure ,Infectious Diseases ,Risk groups ,Nitrofurantoin ,Diabetes mellitus ,Internal medicine ,Urinary Tract Infections ,Diabetes Mellitus ,Humans ,Medicine ,Female ,Medical prescription ,business ,Retrospective Studies ,medicine.drug - Abstract
Objective To compare the effectiveness of five versus seven days of nitrofurantoin treatment for urinary tract infection (UTI) in diabetic women. Methods Data were collected retrospectively from Dutch general practitioners between 2013 and 2020. Nitrofurantoin prescriptions with a duration of five (5DN) or seven days (7DN) in women with diabetes were included. Inverse propensity weighting (IPW) was performed to calculate adjusted risk differences (RD) for treatment failure within 28 days. Secondary outcomes were 14-day treatment failure, severe treatment failure, and 28-day treatment failure in defined risk groups. Results Nitrofurantoin was prescribed in 6866 episodes, 3247 (47,3%) episodes with 5DN and 3619 (52,7%) episodes with 7DN. Patients in the 7DN group had more co-morbidities, more diabetes-related complications and were more insulin-dependent. There were 517/3247 (15.9%) failures in the 5DN group versus 520/3619 (14.4%) in the 7DN group. The adjusted RD for failure within 28 days was 1.4% (95% CI -0.6 to 3.4). Conclusion We found no clinically significant difference in treatment failure in diabetic women with UTI treated either five or seven days with nitrofurantoin within 28 days. A 5-day treatment should be considered to reduce cumulative nitrofurantoin exposure in DM patients.
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- 2022
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6. Presenting Features and Clinical Course of Chronic Nitrofurantoin-Induced Lung Toxicity
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Antonios Charokopos, Jay H. Ryu, Effrosyni D. Manali, Vasilios Tzilas, Spyridon Papiris, Lykourgos Kolilekas, and Demosthenes Bouros
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Lung Diseases ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Drug-Related Side Effects and Adverse Reactions ,business.industry ,Lung toxicity ,Anti-Infective Agents, Urinary ,Clinical course ,Graft vs Host Disease ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Nitrofurantoin ,Internal medicine ,Urinary Tract Infections ,medicine ,Humans ,Female ,Cardiology and Cardiovascular Medicine ,business ,Lung ,medicine.drug - Published
- 2022
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7. Nitrofurantoin 100 mg versus 50 mg prophylaxis for urinary tract infections
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Thijs ten Doesschate, Anouk E. Muller, Irene A.M. Groenewegen, Kelly Hendriks, T.N. Platteel, Suzanne E. Geerlings, Andy I.M. Hoepelman, Evelien C. van der Hout, Cornelis H. van Werkhoven, Marc J. M. Bonten, Medical Microbiology & Infectious Diseases, Infectious diseases, AII - Infectious diseases, and APH - Quality of Care
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Nausea ,Urinary system ,030106 microbiology ,Anti-Infective Agents, Urinary ,urologic and male genital diseases ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Interquartile range ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Pneumonitis ,First episode ,Urinary tract infection ,Prophylaxis ,business.industry ,Hazard ratio ,General Medicine ,Primary care ,medicine.disease ,female genital diseases and pregnancy complications ,Infectious Diseases ,Nitrofurantoin ,Urinary Tract Infections ,Female ,medicine.symptom ,business ,Cohort study ,medicine.drug - Abstract
Objectives: Guidelines do not distinguish between 50 mg or 100 mg nitrofurantoin as daily prophylaxis for recurrent urinary tract infection (UTI), although 50 mg might have a better safety profile. Our objective was to compare the effectiveness and safety of both regimens. Methods: Data were retrospectively collected from 84 Dutch GP practices between 2013 and 2020. Nitrofurantoin prescriptions of 100 mg and 50 mg every 24 hours in women were included. Cox proportional hazard regression analysis was used to calculate hazard ratios on first episode of UTI, pyelonephritis and (adverse) events. Patients were followed for the duration of consecutive repeated prescriptions, assuming non-informative right censoring, up to 1 year. Results: Nitrofurantoin prophylaxis was prescribed in 1893 patients. Median lengths of follow up were 90 days (interquartile range (IQR) 37–179 days) for 100 mg (n = 551) and 90 days (IQR 30–146 days) for 50 mg (n = 1342) with few differences in baseline characteristics between populations. Under 100 mg and 50 mg, 82/551 (14.9%) and 199/1342 (14.8%) developed UTI and 46/551 (8.3%) and 81/1342 (6.0%) developed pyelonephritis, respectively. Adjusted HRs of 100 mg versus 50 mg were 1.01 (95% CI 0.78–1.30) on first UTI, 1.37 (95% CI 0.95–1.98) on first pyelonephritis episode, 1.82 (95% CI 1.20–2.74) on first consultation for cough, 2.68 for dyspnoea (95% CI 1.11–6.45) and 2.43 for nausea (95% CI 1.03–5.74). Conclusion: Daily prophylaxis for recurrent UTI with 100 mg instead of 50 mg nitrofurantoin was associated with an equivalent hazard on UTI or pyelonephritis, and a higher hazard on cough, dyspnoea and nausea. We recommend 50 mg nitrofurantoin as daily prophylaxis.
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- 2022
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8. Comparative Minimal Inhibitory and Mutant Prevention Concentration of Eight Antimicrobial Agents Against Klebsiella pneumoniae
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Ping Chen, Fan Yang, Hafiz Muhammad Ishaq, Wei Liao, Huiyuan Wang, Sisi Wang, and Xiaoyu Xing
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Microbiology (medical) ,Pharmacology ,Imipenem ,biology ,business.industry ,Klebsiella pneumoniae ,Immunology ,Tigecycline ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,biology.organism_classification ,Microbiology ,Minimum inhibitory concentration ,Levofloxacin ,Amikacin ,Nitrofurantoin ,polycyclic compounds ,Colistin ,Medicine ,business ,medicine.drug - Abstract
Purpose: With the emergence of multidrug-resistant and pan-resistant strains, Klebsiella pneumoniae (K. pneumoniae) shows higher treatment failure rates and mortality in clinics. It is more important to develop an effective method for treating K. pneumonia infections. The main objectives of this study were to determine the minimal inhibitory concentration (MIC) and the mutant prevention concentration (MPC) for eight antimicrobial agents against K. pneumoniae isolated from different hosts and compare the emergence of resistant mutants between animal strains and human strains. Materials and Methods: A total of 72 nonduplicate K. pneumoniae isolates and 8 antimicrobial agents (amikacin, azithromycin, levofloxacin, doxycycline, nitrofurantoin, colistin, tigecycline, and imipenem) were used. The MIC and MPC values were determined using agar plate assays. The values of the selection index (SI) were calculated with MPC90/MIC90. Pharmacodynamic parameters were calculated using published plasma pharmacokinetic variables. Results: For human isolate strains, the MPC50/90 (μg/mL) values were as follows: amikacin, 32/128; azithromycin, 64/128; levofloxacin, 4/16; doxycycline, 32/32; nitrofurantoin, 128/512; colistin, 4/8; tigecycline, 8/16; and imipenem, 4/8. The value of SI was 8 for azithromycin, doxycycline, and tigecycline; 16 for amikacin, levofloxacin, and nitrofurantoin; 4 for imipenem; and 2 for colistin. For animal isolate strains, the MPC90 values were 128 μg/mL for azithromycin and doxycycline, 64 μg/mL for amikacin, 32 μg/mL for levofloxacin, 512 μg/mL for nitrofurantoin, 8 μg/mL for colistin and tigecycline, 4 μg/mL for imipenem. The value of SI was 2 for colistin and imipenem, 8 for tigecycline, 16 for amikacin, and 32 for the other four agents. In combination with pharmacokinetic parameters, these findings indicated that the plasma concentrations of the seven antibiotics except imipenem were below the MPC for the entire dosing interval. Conclusion: The ability of eight antibiotics to prevent resistant mutants of K. pneumoniae was different between animal strains and human strains. Higher doses than those currently approved should be required to prevent the enrichment of mutants of drug-resistant bacteria in the clinics.
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- 2022
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9. ANI Pharmaceuticals Announces the FDA Approval and Launch of Nitrofurantoin Oral Suspension USP
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United States. Food and Drug Administration -- International economic relations ,IMS Health Inc. -- International economic relations ,ANI Pharmaceuticals Inc. -- International economic relations ,Generic drugs ,Nitrofurantoin ,Computer services industry -- International economic relations ,Health care industry -- International economic relations ,Drug approval ,Oral medication ,Pharmaceutical industry -- International economic relations ,Health care industry ,Computer services industry ,Business ,Business, international - Abstract
BAUDETTE, Minn. -- ANI Pharmaceuticals, Inc. (ANI or the Company) (Nasdaq: ANIP) today announced that it received U.S. Food and Drug Administration (FDA) approval for the Abbreviated New Drug Application [...]
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- 2023
10. Resistência aos antibióticos de uso oral a partir de isolados de urina de pacientes não hospitalizados
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Maria Eduarda Campos Bezerra, Rosilma Melo, and Francisco Montenegro
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medicine.medical_specialty ,Staphylococcus saprophyticus ,biology ,business.industry ,Sulfamethoxazole ,Amoxicillin ,biology.organism_classification ,Microbiology ,Trimethoprim ,Ciprofloxacin ,Nitrofurantoin ,Internal medicine ,medicine ,Outpatient clinic ,business ,Cefuroxime ,medicine.drug - Abstract
O índice da resistência antimicrobiana (RAM) cresce progressivamente no mundo e acaba limitando a eficácia de tratamento de doenças comuns, como a infecção do trato urinário (ITU). Além disso, na atualidade, a RAM é apontada como um dos principais problemas de saúde pública. Diante do exposto, o objetivo do presente estudo foi avaliar a resistência bacteriana frente aos antibióticos orais mais comumente utilizados para o tratamento das ITU em pacientes ambulatoriais, bem como a identificação das bactérias isoladas. Foi realizado um estudo observacional experimental com abordagem quantitativa no período de janeiro a maio de 2019, desenvolvido em um hospital privado de alta complexidade localizado na cidade do Recife, PE. Foram incluídas no estudo todas as uroculturas positivas de pacientes adultos atendidos no ambulatório do referido hospital, onde foi utilizado, para a identificação bacteriana, o equipamento MALDI – TOF (Matrix Associated Laser Desorption-Ionization – Time of Flight). Foram analisadas um total de 379 amostras positivas de uroculturas, das quais 16 (4,2%) representavam espécies sem interesse clínico, pois obtiveram uma porcentagem de frequência muito baixa, bem como 327 (86,3%) pertenciam a três espécies de bactérias Gram-negativas: Escherichia coli (72,8%), Klebsiella pneumoniae (16,2%) e Proteus mirabilis (11%). Enquanto nas 36 (9,5%) amostras foram identificadas duas espécies Gram-positivas: Staphylococcus saprophyticus (66,7%) e Enterococcus faecalis (33,3%). Foi possível observar que o antibiótico oral com maior percentual de resistência foi o sulfametoxazol + trimetoprima com 24,5% seguido da ciprofloxacina com 22,1%, cefuroxima (16,7%), amoxicilina + clavulanato (13,0%) e nitrofurantoína (8,1%). De acordo com recomendação, é excluído o uso de antibióticos que apresentarem resistência acima de 20%, desta forma os únicos antibióticos por via oral que possui perfil terapêutico adequado para o tratamento empírico dos pacientes adultos com ITU na região do presente estudo são cefuroxima, amoxicilina + clavulanato e nitrofurantoína.
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- 2021
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11. Role of routine urine culture in predicting asymptomatic bacteriuria in pregnancy and the prevalence of asymptomatic bacteriuria in pregnant women - Our experience
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Tina Singh, Shazia Khan, and Aparna Krishnamurthy
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medicine.medical_specialty ,Pregnancy ,business.industry ,Obstetrics ,Incidence (epidemiology) ,Urine ,Bacteriuria ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,Preeclampsia ,Obstetrics and gynaecology ,Nitrofurantoin ,medicine ,Dysuria ,medicine.symptom ,business ,medicine.drug - Abstract
Introduction: Asymptomatic bacteriuria (ASB) in pregnancy can flare into frank pyelonephritis and sepsis if untreated due to the low immunity. Apart from causing morbidity in mothers it affects the foetus by increasing the incidence of prematurity and IUGR. The present study was undertaken to determine the prevalence of ASB in the pregnant women attending Ante natal clinic and the significance of routine urine culture. Materials and Methods : Total 310 pregnant women attending the antenatal OPD were enrolled in the study over a period of 10 months. Inclusion criteria included all pregnant women attending antenatal OPD without any urinary symptoms or history of fever. Exclusion criteria included frank UTI symptoms like fever, dysuria, increased frequency of urine, any history of intake of antibiotics, any urinary tract anomaly or renal calculi. Their midstream urine sampling was collected and subjected to both microscopy and culture sensitivity; standard microbiological method was used. Results: The prevalence of ASB was found to be 11.29% and was maximum in second trimester (54.2%). The study revealed routine urine culture is a sensitive test to diagnose ASB. The commonest bacterium isolated was Escherichia coli (51.4% cases) and the most effective antibiotic was Nitrofurantoin. The neonatal outcomes are discussed in the text while no perinatal deaths were recorded during the period of study. No direct association of asymptomatic bacteriuria with anaemia and preeclampsia was found, but odds ratio was more than one. Conclusion: The study highlights that asymptomatic bacteriuria is a common occurrence in pregnant women, including urine culture as a part of routine investigation in antenatal patients can help diagnose this condition. Prompt treatment of ASB can prevent any obstetric complication arising from the flareup of asymptomatic bacteriuria in pregnancy and thus reduce maternal and foetal morbidity. Keywords: Asymptomatic bacteriuria, Trimester, Pyeloneph
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- 2021
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12. Efficacy and safety of quinolones vs. other antimicrobials for the treatment of uncomplicated urinary tract infections in adults: a systematic review and meta-analysis
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Yuting Jia, Yun Cai, Man Zhu, Jin Wang, and Kaicheng Yan
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Adult ,medicine.medical_specialty ,medicine.drug_class ,Urology ,Quinolones ,Cochrane Library ,Fosfomycin ,beta-Lactams ,urologic and male genital diseases ,law.invention ,Antibiotic resistance ,Anti-Infective Agents ,Randomized controlled trial ,law ,Internal medicine ,Trimethoprim, Sulfamethoxazole Drug Combination ,medicine ,Humans ,business.industry ,Incidence (epidemiology) ,Obstetrics and Gynecology ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,Quinolone ,female genital diseases and pregnancy complications ,Clinical trial ,Nitrofurantoin ,Urinary Tract Infections ,business ,medicine.drug - Abstract
In the present study, we aimed to compare the efficacy and safety of quinolones with trimethoprim-sulfamethoxazole (TMP/SMX), nitrofurantoin, fosfomycin, and β-lactams for the treatment of uncomplicated urinary tract infections (UTIs) in adults. All controlled clinical trials assessing quinolones for uncomplicated UTIs in adults were searched from PubMed, Embase, and Cochrane Library databases. Meta-analyses were used to evaluate the efficacy and safety in randomized controlled trials (RCTs). A total of 47 RCTs consisting of 8992 patients were included in the present analysis. The clinical and bacteriological remission rates of quinolones were significantly higher (P
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- 2021
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13. Comparison of Single Antibiotic Paste Nitrofurantoin and Calcium Hydroxide Paste as Intracanal Medicaments in Alleviating Post-Operative Pain in Patients with Symptomatic Irreversible Pulpitis -A Randomized Controlled Trial
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Abhishek Lal, Ammara Shamim Jaffrani, and Hira Abbasi
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Calcium hydroxide ,medicine.drug_class ,business.industry ,Root canal ,Antibiotics ,law.invention ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Randomized controlled trial ,law ,Nitrofurantoin ,Anesthesia ,medicine ,Symptomatic irreversible pulpitis ,In patient ,business ,Post operative pain ,medicine.drug - Abstract
Aims: This study aims to compare the efficacy in alleviating pain between intracanal medicaments, namely Nitrofurantoin and Calcium Hydroxide Paste. Study Design: Randomized Controlled Trial. Place and Duration of Study: Sample: Department of Operative Dentistry, Sir Syed College of Medical Sciences, Pakistan, between January 2021 and May 2021. Methodology: 60 patients were randomly divided into 3 groups, each group having 20 patients as following: Group 1: Nitrofurantoin, Group 2: Calcium Hydroxide and Group 3: Control. Preoperative pain was recorded using a numerical pain scale. After access preparation, chemomechanical preparation was performed with subsequent placement of intracanal medicaments. Pre-operative pain score was initially recorded, followed by post-operative pain at 12, 24, 48, and 72 hours, respectively. Root canal treatment was performed in single rooted teeth with patients suffering from symptomatic irreversible pulpitis Results: Majority of the patients in all 3 groups were initially presented with moderate to severe pre-operative pain. After 72 hours post-operatively, 50% patients in Group 1 reported no pain, while 5% patients in both Group 2 and 3 had no pain. Pain significantly subsided in Group 1 as compared to Group 2 and 3. Regarding age and gender, both had no significant relationship with the pain scores in all of the 3 groups Conclusion: Nitrofurantoin has been proven to be an effective intracanal medicament in alleviating immediate post-operative pain in patients with symptomatic irreversible pulpitis as compared to calcium hydroxide. While the control group with no intracanal medicament showed little reduction in pain scores. So, nitrofurantoin can be used as a substitute to currently available standard intracanal medicaments.
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- 2021
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14. Caracterización molecular de enterobacterias multirresistentes en dos departamentos de la selva peruana
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Antonio Burgos-Espejo, Alexander Fajardo-Loyola, Diana León-Luna, José Yareta-Yareta, Pool Marcos-Carbajal, Marco Galarza-Pérez, and Carlos Peralta-Siesquen
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RC955-962 ,Common gene ,farmacorresistencia microbiana ,resistencia betalactámica ,Antimicrobial susceptibility ,Microbial Sensitivity Tests ,Drug resistance ,beta-Lactamases ,General Biochemistry, Genetics and Molecular Biology ,Microbiology ,law.invention ,beta-lactam resistance ,law ,Arctic medicine. Tropical medicine ,Ampicillin ,Peru ,Escherichia coli ,medicine ,Humans ,genes ,Escherichia coli Infections ,Polymerase chain reaction ,Retrospective Studies ,drug resistance, microbial ,biology ,business.industry ,biology.organism_classification ,Enterobacteriaceae ,Anti-Bacterial Agents ,Nitrofurantoin ,Comunicación Breve ,Urinary Tract Infections ,Medicine ,business ,enterobacteriaceae ,medicine.drug - Abstract
Introduction. The emergence of multiresistant enterobacteria producing extendedspectrum beta-lactamase (ESBL) in outpatients with urinary tract infections represents a public health problem in Perú. Objectives. To characterize multiresistant enterobacteria isolated from patients diagnosed with urinary tract infection in two Peruvian jungle departments using molecular techniques. Materials and methods. We conducted a descriptive, observational, and retrospective study of 61 urine culture isolates from two departments in the Peruvian jungle during 2017-2018. Resistance profiles were identified using the MicroScan™ automated system and a conventional polymerase chain reaction (PCR) was used for the detection of blaCTX-M, blaTEM and blaSHV genes. Results. The most common positive ESBL enterobacteria for each department were Escherichia coli in Madre de Dios (10/40; 25%) and Ucayali (16/21; 76.2%). Gene blaCTX-M was the most prevalent in both departments (25/61; 41%), followed by blaTEM (15/61; 24.6%), and blaSHV (10/61; 16.4%). As for the antimicrobial susceptibility profile, we detected resistance levels of 72.6% for ampicillin, 82.3% for cephalothin, and 88.7% for nitrofurantoin. Conclusions. BLEE-producing multi-resistant enterobacteria strains in both departments were 57.4% and blaCTX-M was the most common gene.Introducción. La aparición de enterobacterias multirresistentes y productoras de betalactamasas de espectro extendido (BLEE) en pacientes de consulta externa con infecciones urinarias, representa un problema de salud pública en Perú. Objetivos. Caracterizar molecularmente enterobacterias multirresistentes aisladas de pacientes con diagnóstico de infección urinaria y procedentes de dos departamentos de la selva peruana. Materiales y métodos. Se hizo un estudio descriptivo, observacional y retrospectivo de 61 aislamientos de urocultivo procedentes de la selva peruana durante 2017 y 2018. Los perfiles de resistencia se identificaron utilizando el sistema automatizado MicroScan™ y para la detección de los genes blaTEM, blaCTX-M, blaSHV se empleó una reacción en cadena de la polimerasa (PCR) convencional. Resultados. Las enterobacterias positivas para BLEE más frecuentes por departamento fueron Escherichia coli en Madre de Dios (25 %, 10/40) y Ucayali (76,2 %, 16/21). En ambos departamentos, el gen blaCTX-M fue el más frecuente (25/61; 41 %), seguido por blaTEM (15/61; 24,6 %) y blaSHV (10/61; 16,4 %). En el perfil de sensibilidad antimicrobiana, se detectó 72,6 % de resistencia contra ampicilina, 82,3 % contra cefalotina y 88,7 % contra nitrofurantoína. Conclusiones. El porcentaje de cepas de enterobacterias multirresistentes productoras de BLEE en ambos departamentos fue del 57,4 % y el gen bla CTX-M fue el más frecuente.
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- 2021
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15. Prenatal exposure to nitrofurantoin and risk of childhood leukaemia: A registry-based cohort study in four Nordic countries
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Sarah Hjorth, Maarit K. Leinonen, Marie Hargreave, Hedvig Nordeng, Anne Broe, Ulrika Nörby, Caroline H. Hemmingsen, and Anton Pottegård
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Pediatrics ,medicine.medical_specialty ,Epidemiology ,Population ,Scandinavian and Nordic Countries ,Cohort Studies ,chemistry.chemical_compound ,symbols.namesake ,Pregnancy ,Risk Factors ,Humans ,Medicine ,Registries ,Poisson regression ,Child ,education ,education.field_of_study ,Leukemia ,business.industry ,Confounding ,Absolute risk reduction ,Infant ,Amdinocillin Pivoxil ,General Medicine ,Confidence interval ,Pivmecillinam ,Nitrofurantoin ,chemistry ,Prenatal Exposure Delayed Effects ,symbols ,Female ,business ,Cohort study ,medicine.drug - Abstract
Background Studies have suggested increased risks of childhood leukaemia after prenatal exposure to antibiotics, particularly nitrofurantoin. However, these findings may be related to the underlying maternal infection. This multinational study aimed to investigate the association between prenatal nitrofurantoin exposure and childhood leukaemia while accounting for maternal infection. Methods In a population-based cohort study of children born in Denmark, Finland, Norway or Sweden from 1997 to 2013, prenatal exposure to nitrofurantoin or pivmecillinam (active comparator) was ascertained from national Prescription Registries. Childhood leukaemia was identified by linkage to national Cancer Registries. Poisson regression was used to estimate incidence rate ratios (IRRs) and incidence rate differences (IRDs) with inverse probability of treatment weights applied to account for confounding. Results We included 44 091 children prenatally exposed to nitrofurantoin and 247 306 children prenatally exposed to pivmecillinam. The children were followed for 9.3 years on average (standard deviation 4.1). There were 161 cases of childhood leukaemia. The weighted IRR for prenatal nitrofurantoin exposure when compared with pivmecillinam was 1.34 (95% confidence interval 0.88, 2.06), corresponding to an IRD of 15 per million person-years. Higher point estimates were seen for first- and third-trimester exposure. There was no evidence of a dose–response relationship. Conclusions Prenatal exposure to nitrofurantoin was not substantially associated with childhood leukaemia, although a slightly elevated IRR with confidence intervals including the null was observed, corresponding to a small absolute risk. The lack of a dose–response relationship and a clear biological mechanism to explain the findings suggests against a causal association.
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- 2021
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16. Bacteriological Profile and Antibiotic Sensitivity Pattern in Patients with Urinary Tract Infection in Janakpurdham, Nepal
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Shambhu Kumar Sah, Digbijay Kumar Thakur, and Rameshwar Mahaseth
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medicine.medical_specialty ,Klebsiella ,biology ,medicine.drug_class ,business.industry ,Urinary system ,Antibiotic sensitivity ,Antibiotics ,biology.organism_classification ,Amikacin ,Nitrofurantoin ,Internal medicine ,medicine ,Ceftriaxone ,Gentamicin ,business ,medicine.drug - Abstract
Background: Urinary tract infections are most common bacterial infection in routine clinical practice. It is also most common nosocomial infection in many hospitals. Antibiotics are usually given empirically before urine culture reports available and treatment failure rate used to be significantly high. Study of causative agents and their antimicrobial sensitivity pattern are important factors helping formulating antibiotic policy. Generally, most common uropathogene is Escherichia Coli. Tertiary care hospitals, catering of already partially treated or mal treated patients as major chunk, may have varying etiologies and different sensitivity patterns. Objective: To study the culture and sensitivity patterns of urinary tract infections in patients presenting with urinary symptoms in local hospitals. Study design: A cross sectional study Materials and methods: Study was conducted at Madanta Research Clinic Private Limited from 12th march 021 to 12th September 021. Urine from cases suspected to have symptoms suggestive of UTI were send for bacteriological culture and sensitivity. Demographic profiles of each participant along with pathogen isolated, culture sensitivity pattern was documented. Data analysis was done in IBM spss 25. Results: A total 200 samples were selected for bacteriological culture and sensitivity out of which 32% were male and 68% were female. Around 50% of participants were in age group 20-40. There was no growth in 64% sample. Among positive samples (36%), E. coli (most common) was detected in 91.66%, Klebsiella was detected in 6.94%. Gentamicin, Amikacin and Nitrofurantoin were most common antibiotics sensitive to organisms in culture and Cephalosporins group of antibiotics are commonly resistant. Conclusions: coli is the most common organism isolated in urine culture in our region Janakpur. Cephalosporins are resistant in majority of cases where as Aminoglycosides like Amikacin, Gentamicin and Nitrofurantoin are found to be highly sensitive in most of positive cases.
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- 2021
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17. Urinary Infections in Pregnancy Conditions
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Vigila J and Kalpana Thalava
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medicine.medical_specialty ,business.industry ,Urinary system ,media_common.quotation_subject ,Erythromycin ,Bacteriuria ,Amoxicillin ,medicine.disease ,Urination ,Urethra ,medicine.anatomical_structure ,Nitrofurantoin ,Internal medicine ,medicine ,Kidney infection ,business ,medicine.drug ,media_common - Abstract
The urinary tract infections (UTI’s) are common infections that can affect kidneys, ureters, and urethra. About 40% of urinary tract infections are caused during hospitalization and globally an estimated 600,000 patients are affected per year. Urinary tract infections are more prevalent in women due to their short urethra and its anatomical proximity to the anal orifice. A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine. A kidney infection may cause back pain, nausea, vomiting and fever. Bacteriuria is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. This study was carried out to isolate and identify bacteria involved in the first trimester of pregnancy. A cross sectional study was conducted from February, 2019 to June 2019. Structured questionnaires were used to collect data from pregnant women. UTI was diagnosed by urine culture on standard culture media. Out of 25 pregnant women included in this study, 15 (60.0%) were symptomatic and 10 (40.0%) asymptomatic. Escherichia coli(64%) was the most commonly found bacterial isolate followed by Psedomonas aeruginosa (20%), Klebsiella sp. (12%) and Proteus sp. (0.4%). Antibiotic susceptibility test by Kirby-Bayer Disc diffusion method revealed that all the bacterial isolates subjected to antibiogram test were sensitive or susceptible to Gentamycin, Nalidixic acid, Nitrofurantoin, Amikacin and Co-trimoxazole, and resistant to Amoxicillin, Norfloxacin and erythromycin were resistant to all bacterial isolates.
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- 2021
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18. Antimicrobial Susceptibility Sensitivity Pattern in Positive Urine Culture for Urinary Tract Pathogens from Tertiary Care Hospital
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Sahana John and A R. Mahesh
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biology ,business.industry ,medicine.drug_class ,Klebsiella pneumoniae ,Antibiotics ,Antimicrobial ,biology.organism_classification ,Microbiology ,Antibiotic resistance ,Nitrofurantoin ,Ampicillin ,Colistin ,Medicine ,Vancomycin ,business ,medicine.drug - Abstract
Hospital specific monitoring studies aims to determine the prevalence of the type of microorganisms that causes urinary infections and to assess the antimicrobial sensitivity pattern. A hospital based short term prospective cross-sectional study was conducted at Sagar Hospital, Bengaluru from August to October 2020. Antimicrobial susceptibility in MIC test was performed for the isolated pathogens by using automated VITEK compact method and stratification was done according to ICU and NON-ICU patients with over 260 urine culture tests of the suspected in-patient for urinary tract infection. All antimicrobial susceptibility data was analyzed using WHONET software 5.6. Sixty-six urine culture tests showed culture positive, 41 from non-ICU and 23 from ICU. Gram-negative bacilli E.Coli (61% in ICU, 52% IN non-ICU) was the most prevalent bacterium, followed by Klebsiella pneumoniae ss. pneumoniae (9% in ICU, 20% IN non-ICU), and Candida albicans 9% prevalence was seen only in ICU isolates. The study shows that the rate of resistance towards ampicillin (100%) was high among gram negative isolates and penicillin (100%) among gram positive isolates. The susceptibility was favorable towards polymixinB, colistin in gram negative organisms and nitrofurantoin, vancomycin in gram positive organisms. The present study revealed that E.Coli is the predominant bacterial pathogen. It also demonstrates there is an increasing resistance to ampicillin (88.2%) and ESBL (90%) among UTI pathogens. While, polymixin B (100%) and colistin was found most effective among gram negative and nitrofurantoin was most effective among gram positive organisms. Keywords: Antibiotic, antimicrobial resistance, urinary tract infection
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- 2021
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19. Detection of biofilm formation, extended spectrum beta lactamase production and their correlation with antibiotic resistance among uropathogenic Escherichia coli
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D. E. Premlatha and Vijetha Sajjanar
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Imipenem ,business.industry ,Antibiotic sensitivity ,Aztreonam ,biochemical phenomena, metabolism, and nutrition ,Fosfomycin ,bacterial infections and mycoses ,Microbiology ,Ciprofloxacin ,chemistry.chemical_compound ,chemistry ,Nitrofurantoin ,Amikacin ,polycyclic compounds ,Medicine ,business ,MacConkey agar ,medicine.drug - Abstract
Background: Urinary tract infections (UTI) are most common bacterial infections encountered in clinical practice and E.coli is predominant organism causing UTI. Objectives of the study: 1. To study antibiotic resistance pattern among uropathogenic E.coli (UPEC). 2. To study extended spectrum beta lactamase (ESBL) production and their correlation with antibiotic resistance among uropathogenic E.coli (UPEC). 3. To study biofilm formation and its correlation with antibiotic resistance among uropathogenic E.coli (UPEC). Materials and Methods: A prospective study was conducted on first 100 Escherichia coli isolated from urine specimens of patients suspected to be having urinary tract infection between January 2016 and December 2016 received at Department of Microbiology, SIMS Shimoga. Fresh midstream urine samples were aseptically collected in sterile containers and plated on Blood agar & MacConkey agar plates using a standard loop technique & the growth was processed by standard bacteriological technique. Biofilm detection was done by tube and microtitre plate method. ESBL detection was done according to CLSI criteria. Antimicrobial sensitivity testing was done using Kirby-Bauer methods on Mueller-Hinton agar. Results were interpreted as per the CLSI guidelines. Result: Antibiotic sensitivity of E.coli was nitrofurantoin (100%) fosfomycin (100%) imipenem (77%) cotrimoxazole (61%) amikacin (47%) aztreonam (53%) piperacillintazobactam (41%). cefotaxim (25%) ceftazidime (32%) norfloxacin (20%) ampicillin-sulbactam (12%) ciprofloxacin (15%), levofloxacin (12%), amoxiclavulanicacid (15%). ESBL positive were 83% (screening), 80% (confirmatory). Biofilm positive were 63% (tube method) 79% (Microtiterplate method). Conclusion: This study showed Fosfomycin and Nitrofurantoin were the most sensitive drug. Study shows antibiotic resistance was seen more in ESBL and Biofilm producers compared to non ESBL and non biofilm producers. Keywords: Antibiotic resistance
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- 2021
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20. Evaluating Empiric Therapy for Acute Uncomplicated Cystitis in the Outpatient Setting: A Retrospective Cohort Study
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Steven F. Nerenberg and Kayla M. Natali
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medicine.medical_specialty ,Cefazolin ,Emergency Nursing ,03 medical and health sciences ,0302 clinical medicine ,Ambulatory care ,Internal medicine ,Cystitis ,Outpatients ,Escherichia coli ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,business.industry ,Sulfamethoxazole ,030208 emergency & critical care medicine ,Retrospective cohort study ,Emergency department ,Trimethoprim ,Anti-Bacterial Agents ,Nitrofurantoin ,Urinary Tract Infections ,business ,Empiric therapy ,medicine.drug - Abstract
Objectives To evaluate the empiric therapy prescribed for acute uncomplicated cystitis in the outpatient setting (emergency department and ambulatory care clinics) and to characterize uropathogens for discordance between the therapy prescribed and susceptibility. Methods A retrospective review was conducted at an inner-city emergency department and multiple clinics to evaluate the empiric therapy prescribed and the uropathogens isolated from culture for patients with acute uncomplicated cystitis. Results A total of 144 urine cultures were included. Among the patients, 53.4% were empirically prescribed cephalexin, 20.1% ciprofloxacin, 11% nitrofurantoin, and 8.3% trimethoprim/sulfamethoxazole. The most common uropathogen was Escherichia coli (72.4%), followed by Streptococcus agalactiae (7.6%) and Klebsiella pneumoniae (4.8%). Of the 107 E. coli isolates, 9 were extended spectrum beta-lactamase–producing. E. coli antimicrobial susceptibilities were as follows: ceFAZolin (97%), nitrofurantoin (96%), cefTRIAXone (91%), ciprofloxacin (87%), and trimethoprim-sulfamethoxazole (59%). The concordance rates with the Infectious Diseases Society of America treatment guidelines for acute uncomplicated cystitis and local resistance patterns were as follows: empiric therapy prescribed (70%), dosing of empiric therapy (77%), and duration of empiric therapy (22%). For empiric therapy prescribed and susceptibility mismatch, 5.6% of the isolates were not susceptible to therapy, 76.4% were susceptible to therapy, 14% did not have susceptibilities, and 4.2% did not receive therapy. Conclusions Most of the cases of acute uncomplicated cystitis at the subject institution can be managed safely and effectively with nitrofurantoin or first-generation cephalosporins. Institutions should use national guidelines in conjunction with local resistance and prescribing patterns to improve antibiotic prescribing in the outpatient setting.
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- 2021
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21. Antibiotic susceptibility profile of extended spectrum β-lactamase producing Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca from Urinary tract infections
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M. Sharmal Kumar, N. Arunagirinathan, and M. Ravikumar
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biology ,business.industry ,Klebsiella pneumoniae ,medicine.drug_class ,Urinary system ,Antibiotics ,Klebsiella sp ,Klebsiella oxytoca ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease_cause ,Microbiology ,Multiple drug resistance ,Nitrofurantoin ,polycyclic compounds ,bacteria ,Medicine ,Pharmacology (medical) ,business ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,Escherichia coli ,medicine.drug - Abstract
The aim of this study was to analyze the extended spectrum β-lactamases (ESBLs) production and antibiotic susceptibility profile of urinary tract infected bacterial pathogens such as Escherichia coli and Klebsiella spp. A total of 143 Gram-negative bacteria were isolated from people suffering from urinary tract infections (UTIs) were included in this study. Among them, Escherichia coli (75%) were the predominantly isolated bacterial pathogen followed by Klebsiella oxytoca (14.6%) and K. pneumoniae (10.4%). Approximately 65% (n=93) of isolates were positive for ESBL production and E.coli was found to be the highest ESBL producer (67.6%) followed by K. oxytoca (57.1%) and K. pneumoniae (53.3%). E. coli showed high level of 86.1% resistance to cefotaxime and cefuroxime and 100% sensitive to imipenem and meropenem, whereas, K. oxytoca showed high level of 90.5% resistance to cefuroxime and 100% sensitive to amikacin, imipenem and meropenem. Similarly, K. pneumoniae showed high level of 73.3% resistance to nitrofurantoin and 93.3% sensitive to imipenem. This study reveals that majority of UTIs caused bacteria are ESBL producing multidrug-resistant bacteria and showing broad spectrum antibiotic resistance profile.
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- 2021
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22. Evaluation of clinical, etiological and antimicrobial resistance profile of pediatric urinary tract infections in a secondary health care centre
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Hüseyin Burak Özçelik and Gökçe Celep
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Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Urinary system ,Antibiotics ,Population ,Microbial Sensitivity Tests ,Drug resistance ,antibiotics ,susceptibility ,Antibiotic resistance ,Internal medicine ,Drug Resistance, Bacterial ,medicine ,Humans ,Child ,education ,Retrospective Studies ,education.field_of_study ,business.industry ,Retrospective cohort study ,Articles ,General Medicine ,Urinary tract infections ,Anti-Bacterial Agents ,Nitrofurantoin ,Child, Preschool ,Etiology ,Female ,business ,Delivery of Health Care ,medicine.drug - Abstract
Background: Urinary tract infections are common during childhood. The etiologic agents and empirical antibiotics may vary due to age and geographic area. Objectives: This study was designed to investigate the urinary tract infection pathogens, their antibiotic resistance profile and risk factors in a sample of well-child population. Materials and Methods: This retrospective study was conducted in the pediatric clinics of a secondary health-care centre in a one-year period. The source of data was hospital and laboratory records. Toilet trained children and adolescents aged between 5-17 years old with positive urine culture were enrolled into the study. Microbiological studies were conducted ac- cording to international guidelines. Results: During the study 3640 urine samples were analyzed and 342(9.4%) had significant growth. Gram negative en- terobacteria were the most common infectious agents. Antibiotic susceptibility tests showed low cephalosporine resistance unless ESBL was positive. Multi drug resistance was remarkable. Extended beta lactamase resistance rate was 17%. Previous history of antibiotic use before the present administration was the only significant risk factor for ESBL positivity. Conclusion: Treating urinary tract infections may become an emerging problem soon. Unless there are risk factors, cepha- losporines are good options, but if so nitrofurantoin or carbapanems should be preferred for treatment in this population. Keywords: Urinary tract infections; antibiotics; susceptibility.
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- 2021
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23. Extensive drug-resistance in strains of Escherichia coli and Klebsiella pneumoniae isolated from paediatric urinary tract infections
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Muhammad Zahid Mumtaz, Arif Malik, and Zakia Iqbal
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Medicine (General) ,Cefotaxime ,020205 medical informatics ,medicine.drug_class ,Antibiotics ,Ceftazidime ,02 engineering and technology ,Fosfomycin ,Microbiology ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Antibiotic resistance ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,030212 general & internal medicine ,عدوى المسالك البولية ,16S rRNA gene sequencing ,business.industry ,متعددة مقاومة للأدوية ,Multiple drug-resistance ,General Medicine ,Urinary tract infections ,Antimicrobial ,Paediatric infections ,Ciprofloxacin ,Klebsiella pneumoniae ,طب الأطفال ,Nitrofurantoin ,Original Article ,الكلبسيلة الرئوية ,business ,تسلسل الجينات ,medicine.drug - Abstract
الملخص: أهداف البحث: تتزايد التهابات المسالك البولية في الأطفال بسرعة في جميع أنحاء العالم، وعادة ما تكون ناجمة عن البكتيريا المقاومة للأدوية. هذه الدراسة تحدد انتشار التهاب المسالك البولية في الأطفال، وتقيم نمط البكتيريا المقاومة للأدوية من قبل سلالات معزولة من الإشريكية والكلبسيلة عن التهابات المسالك البولية في مرضى الأطفال. طرق البحث: تم عزل السلالات البكتيرية الممرضة للجهاز البولي من المرضى الأطفال بالتهابات المسالك البولية التي تم إدخالها في معهد صحة الطفل بلاهور، باكستان. تم تحديد السلالات من جنس الإشريكية والكلبسيلة، من خلال التوصيف الكيميائي الحيوي، وتعرضت لمقاييس الحساسية للمضادات الحيوية لتحديد البكتيريا المقاومة للأدوية ضد ٢١ من الأدوية المضادة للميكروبات. النتائج: خلال ستة أشهر، تم عزل ما مجموعه ٦٣ من الإشريكية و٣٧ من سلالات الكلبسيلة من ١٣٠ طفلا مصابين بالتهابات المسالك البولية. وأظهرت مقاييس حساسية المضادات الحيوية أن الإشريكية والكلبسيلة لها مقاومة عالية ضد كوأموكسيكلاف، وسيفروكسيم، وسيفيكسيم، وسيفوتاكسيم، وسيفتازيديم، وسيفترياكسون، وسيبروفلوكساسين، وحمض ناليديكسيك، ونورفلوكساسين، وحمض بيبيديمك، وكوتريموكسيزول. ومع ذلك، فقد وجد أن للعقاقير المضادة للميكروبات بما في ذلك بوليميكسين-ب، وكبريتات الكوليستين، والكلورامفينيكول، ونيتروفوارانتون، وفوسفومايسين فاعلية كبرى للتحكم بالسلالات الممرضة للجهاز البولي من القولونية الإشريكيشية والكلبسيلة الرئوية. وتم تحديد السلالات الخمس التي تعاني من أعلى مقاومة ضد المضادات الحيوية المختبرة على أنها سلالات من الإشريكية القولونية والكلبسيلة الرئوية. الاستنتاجات: أظهرت دراستنا أن الإشريكية القولونية والكلبسيلة الرئوية كانت البكتيريا المهيمنة لمقاومة للأدوية من التهابات المسالك البولية المكتسبة من المجتمع في مجموعتنا. وتم الوصول إلى أن هذه البكتيريا الممرضة للجهاز البولي غير مستجيبة للعقارات المستخدمة بشكل روتيني من المضادات الحيوية مثل بيتا اللاكتام، والبيريدوبيريميدين، والكينولون، والفلوروكينولون. قد تكون هذه النتائج مفيدة للأطباء لتعزيز العلاج التجريبي لالتهابات المسالك البولية في الأطفال. Abstract: Objectives: Urinary tract infections (UTIs) in children are rapidly increasing worldwide and are commonly caused by extensively drug-resistant bacteria. This study determines the prevalence of UTIs in paediatric patients and evaluates the pattern of extensively drug-resistance in Escherichia coli and Klebsiella pneumoniae strains isolated from paediatric UTI patients. Methods: Uropathogenic bacterial strains were isolated from paediatric patients with UTIs admitted to the Institute of Child Health, Lahore, Pakistan. Strains of both E. coli and K. pneumoniae were identified using biochemical characterisation and subjected to antibiotic susceptibility assays for 21 common antimicrobial drugs in order to determine their extensively drug-resistant profile. Results: We isolated 63 E. coli and 37 K. pneumoniae strains from 130 paediatric patients with UTIs over a period of six months. The antibiotic susceptibility assays showed that both the E. coli and K. pneumoniae strains exhibited a high degree of resistance against co-amoxiclav, cefuroxime, cefixime, cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, nalidixic acid, norfloxacin, pepedemic acid, and co-trimoxazole. However, several of the antimicrobial agents, including polymyxin B, colistin sulphate, chloramphenicol, nitrofurantoin, and fosfomycin, were found to retain their antimicrobial activities against both pathogens. The five highest antibiotic resistant strains were identified as E. coli strains ZK9, ZK40, and ZK60 and K. pneumoniae ZK32 and ZK89 using 16S rRNA gene sequencing. Conclusion: Our study demonstrates that E. coli and K. pneumonia are the dominant extensively drug-resistant uropathogenic bacteria in community-acquired UTIs in our cohort. These uropathogens were found to be resistant to the majority of the routinely-used classes of β-lactams, pyridopyrimidines, quinolones, and fluoroquinolone antibiotics, and these findings may be useful for clinicians in their treatment of paediatric UTIs.
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- 2021
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24. Uropathogens and their antibiotic susceptibility profile in a tertiary carehospital
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Jyoti Srivastava, Ujjwal Maheshwari, Anjali Agarwal, and Seema Bose
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0301 basic medicine ,medicine.medical_specialty ,business.industry ,medicine.drug_class ,Urinary system ,Antibiotic sensitivity ,030106 microbiology ,Antibiotics ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Antibiotic resistance ,chemistry ,Nitrofurantoin ,Internal medicine ,Linezolid ,medicine ,Vancomycin ,030212 general & internal medicine ,Agar diffusion test ,business ,medicine.drug - Abstract
Background: Urinary tract infections (UTI) are one of the most common infections in the community and hospitals. Uropathogens colonize the urinary tract and may ascend to bladder causing cystitis, if left untreated reach kidneys through ureters can be responsible for acute pyelonephritis and cause renal damage. Aims: The aim of the present study is to determine the prevalence of urinary tract infections and antibiotic susceptibility pattern in a tertiary care hospital. Settings & Design: This is an observational study conducted in Microbiology department, Hind Institute of Medical Sciences, Barabanki. Materials and Methods: A total of 623 urine(mid-stream) samples were collected from indoor and outdoor departments of hospital and culture was done on UTI chromogenic agar using semiquantitative method. Antibiotic sensitivity test was performed using Kirby Bauer disc diffusion method. Results: Prevalence of urinary tract infections is 29% in the study. (43%) is the most common micro-organism isolated followed by (13%), (11%), (10.4%), (8.8%), (3.3%), (1.6%), CONS & (1.1%) and (6.6%). The females(56.6%) are more commonly affected than males. Conclusion: In the present study, beta-lactamase inhibitors and aminoglycosides were effective drugs against gram negative bacteria. Vancomycin and linezolid were sensitive in gram positive bacteria. Nitrofurantoin is the promising drug in cases of uncomplicated UTI, and safe to use in pregnancy. High recurrence rates and antimicrobial resistance are responsible for increasing the burden of disease. It is advised to use the antibiotics judiciously as per the hospital antibiotic policy which will help prevent multidrug resistance micro-organism further reducing morbidity and mortality. Keywords: Escherichia coli, Urinary tract infections, Uropathogens.
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- 2021
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25. Fosfomycin and nitrofurantoin: classic antibiotics and perspectives
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Lucas Souza dos Santos, Cristiane dos Santos, and Octavio L. Franco
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Pharmacology ,medicine.medical_specialty ,business.industry ,medicine.drug_class ,Antibiotics ,Fosfomycin ,Multiple drug resistance ,Pharmacotherapy ,Antibiotic resistance ,Drug development ,Nitrofurantoin ,Drug Discovery ,Medicine ,business ,Intensive care medicine ,medicine.drug ,Pharmaceutical industry - Abstract
Antibiotics are essential molecules for the treatment and prophylaxis of many infectious diseases. However, drugs that combat microbial infections can become a human health threat due to their high and often indiscriminate consumption, considered one of the factors of antimicrobial resistance (AMR) emergence. The AMR crisis, the decrease in new drug development by the pharmaceutical industry, and reduced economic incentives for research have all reduced the options for treating infections, and new strategies are necessary, including the return of some traditional but “forgotten” antibiotics. However, prescriptions for these older drugs including nitrofurantoin and oral fosfomycin, have been based on the results of pioneer studies, and the limited knowledge generated 50–70 years ago may not be enough. To avoid harming patients and further increasing multidrug resistance, systematic evaluation is required, mainly for the drugs prescribed for community-acquired infections, such as urinary tract infections (UTI). Therefore, this review has the objective of reporting the use of two classic drugs from the nitrofuran and phosphonic acid classes for UTI control nowadays. Furthermore, we also explore new approaches used for these antibiotics, including new combination regimes for spectral amplification, and the prospects for reducing bacterial resistance in the fight against bacteria responsible for UTI.
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- 2021
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26. Reintroduction of nitrofurantoin in the treatment of uncomplicated urinary tract infection
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Md. Sayedur Rahman and Sabiha Mahboob
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Pharmacology ,medicine.medical_specialty ,Cure rate ,business.industry ,Urinary system ,RM1-950 ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,urologic and male genital diseases ,Antimicrobial ,Gastroenterology ,female genital diseases and pregnancy complications ,Ciprofloxacin ,Nitrofurantoin ,Internal medicine ,medicine ,Sensitivity pattern ,Therapeutics. Pharmacology ,Uncomplicated urinary tract infection ,business ,medicine.drug - Abstract
The present study was designed to reintroduce an older antimicrobial nitrofurantoin to treat uncomplicated urinary tract infection and to explore the relationship between the reintroduction and corresponding shift in sensitivity pattern of the microbes. The microbial sensitivity against ciprofloxacin before intervention was 46.6%, which significantly increased after intervention (51.8%). Treatment with nitrofurantoin resulted in a total clinical cure rate of 80.6%, of which rate of clinical cure achieved in expected time was 66.1% and delayed was 14.5%. The rate of total clinical cure with nitrofurantoin corresponded closely with the proportion of urinary isolates sensitive to nitrofurantoin. i.e., 86.3%. This preliminary study revealed that revival might be an effective strategy to increase the sensitivity and to delay the emergence of resistance.
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- 2021
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27. Antibiotic prescribing patterns for adult urinary tract infections within emergency department and urgent care settings
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Sanjana Koshy, Amanda Cantin, Marianna Fedorenko, Navya Maddali, and Erick Eiting
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Adult ,Male ,medicine.medical_specialty ,Urinary system ,urologic and male genital diseases ,Logistic regression ,Ambulatory Care Facilities ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Antimicrobial stewardship ,Practice Patterns, Physicians' ,Retrospective Studies ,business.industry ,Sulfamethoxazole ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Emergency department ,Trimethoprim ,female genital diseases and pregnancy complications ,Anti-Bacterial Agents ,Nitrofurantoin ,Urinary Tract Infections ,Emergency Medicine ,Female ,Emergency Service, Hospital ,business ,Fluoroquinolones ,medicine.drug - Abstract
Urinary tract infections (UTI) are a common reason for emergency department (ED) and urgent care (UC) visits. Fluoroquinolones (FQ) are frequently prescribed for treatment of UTI in the outpatient setting; however, data evaluating prescribing patterns after FDA safety warnings is limited, especially in UC. The study goal was to investigate and compare antimicrobial prescribing for UTIs in a single-site ED and an off-site UC in an urban, academic health system. This retrospective study included patients presenting with a UTI to the ED or UC between January and June 2018. Those 18 years or older with uncomplicated, complicated UTI, or pyelonephritis were included. Exclusion criteria were catheter-related UTI, urinary tract abnormalities, immunocompromised, or hospitalization. Primary outcome was FQ prescribing rate for all UTI in the ED and UC. Secondary outcomes were rates of non-FQ prescribing, re-presentation, bug-drug mismatch, and treatment durations. 184 patients were included. FQ prescribing rate was similar in ED and UC (21.2% vs. 16.3%, p = 0.4). Non-FQs prescribed in ED and UC were nitrofurantoin (20.2% vs 53.6%), beta-lactams (46.1% vs 22.6%), and trimethoprim/sulfamethoxazole (12.5% vs. 5%). A longer than recommended duration was identified in 46.3% UC patients compared to 21.2% ED patients. Thirty-day re-presentation with persistent UTI symptoms occurred more frequently in the ED compared to UC (13.5% vs. 7.5%). Predictors of FQ prescribing on logistic regression were male, recurrent UTI, and malignancy. FQ prescribing rate for UTI treatment was low with no difference between ED and UC. Opportunity exists to improve treatment duration and antimicrobial choice.
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- 2021
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28. Bacterial Pattern of Community acquired Urinary Tract Infections: A Challenge for Antimicrobial Resistance
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Nader A. Nemr, Rania M. Kishk, Mohammed Abdou, Hassnaa Nassar, Noha M Abu bakr Elsaid, and Mohamed Aboelmagd
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Imipenem ,medicine.drug_class ,business.industry ,Antibiotics ,Bacteriuria ,bacterial infections and mycoses ,medicine.disease ,Meropenem ,Microbiology ,Ciprofloxacin ,Amikacin ,Levofloxacin ,Nitrofurantoin ,medicine ,business ,medicine.drug - Abstract
Background: Urinary tract infection (UTI) is considered one of the most common bacterial infections seen in health care. To our knowledge, there is no available antimicrobial resistance surveillance system for monitoring of community-acquired UTIs (CA- UTIs) in our country. Objectives: we aimed to discuss the bacterial pattern and resistance profile of CA-UTIs in Ismailia, Egypt. Methods: This cross-sectional study included 400 patients suffering from symptoms of acute UTIs. Urine specimens were collected by clean-catch mid-stream method, examined microscopically and inoculated immediately on blood agar and MacConkey's agar plates. Colony counting, isolation and identification of the urinary pathogens were performed by the conventional biochemical tests according to the isolated organism. Antibiotic susceptibility testing was performed by Kirby Bauer disk diffusion method. Interpretation was performed according to Clinical Laboratory Standard Institute (CLSI) guidelines. Results: out of 400 specimens, 136 of them revealed no bacterial growth or insignificant bacteriuria. Most of participants with UTI were females (81.8%) (p=0.008) and 54.5% of them were married (P=0.1). Gram negative bacteria were more common than Gram positive representing 66 % and 34% respectively. E. coli was the most common isolated organism (39%) followed by S. aureus (32%), K. Pneumoniae and Pseudomonas (10.5% for each), Proteus (6%) and Enterococci (2%). E. coli isolates showed the highest susceptibility to imipenem, meropenem, amikacin, nitrofurantoin, levofloxacin and ciprofloxacin. Most of our patients were diabetics (64.8%) (p=0.004). The mean ± SD of HbA1c was 6.4±2.0 with 4 to 12.6 range, S.E was 0.1 and 95% C.I was 6.2- 6.7. The highest mean ± SD of HbA1c was in S. aureus infections. Conclusion: Gram negative bacteria were most common than Gram positive with predominance of E. coli with significant relation to the presence of diabetes.
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- 2021
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29. Evaluation of sensitivity profiles to fosfomycin in bacterial urine samples from outpatients
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Carlos Augusto Cardozo de Faria, Ana Beatriz Monteiro Fonseca, José Carlos Carraro-Eduardo, Pedro S. Morales, and Rafael Caires Alvino de Lima
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Imipenem ,Veterinary medicine ,medicine.drug_class ,Antibiotics ,Microbial Sensitivity Tests ,Fosfomycin ,03 medical and health sciences ,0302 clinical medicine ,Ampicillin ,Outpatients ,Escherichia coli ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Bacteria ,biology ,business.industry ,Obstetrics and Gynecology ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,Proteus mirabilis ,Anti-Bacterial Agents ,Cross-Sectional Studies ,Reproductive Medicine ,Enterococcus ,Nitrofurantoin ,Urinary Tract Infections ,Gentamicin ,business ,medicine.drug - Abstract
OBJECTIVE To evaluate and compare the susceptibilities of bacteria found in outpatient cultures to fosfomycin and other main antibiotics commonly available in clinical practice. STUDY DESIGN A retrospective cross-sectional study was conducted using 2,673 positive urine cultures collected between 2014 and 2017 at private laboratories located in the cities of Niteroi and Sao Goncalo. Susceptibilities to fosfomycin and other antibiotics were tested using the McNemar test with the level of significance set at 5 %. RESULTS Out of the 2,673 samples tested, 94.1 % were susceptible to fosfomycin. Escherichia coli was responsible for 68.8 % of the positive samples, and susceptibility to fosfomycin was observed in 97.9 % of these cases. Susceptibility to fosfomycin in Klebsiella spp. represented 86.6 % of cases, Enterococcus spp., 94.9 % and Proteus mirabilis, 83.3 %. The highest rate of susceptibility for E. coli was observed with fosfomycin, with the only exception being imipenem (p < 0.001). Klebsiella spp. showed a similar profile, except that there was no difference between susceptibilities to fosfomycin and gentamicin (p = 0.91). Susceptibility of Enterococcus spp. to fosfomycin was like that of nitrofurantoin and ampicillin. Finally, the susceptibility of P. mirabilis to fosfomycin was greater than it was for trimethoprim-sulfamethoxazole and nitrofurantoin. CONCLUSIONS The microbiological profile established here shows substantial sensitivity to fosfomycin in the urine samples analysed. In most cases, there was a sensitivity profile that was favourable to the use of fosfomycin or at least comparable to the other antibiotics studied.
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- 2021
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30. Nitrofurantoin Susceptibility Pattern in Gram-Negative Urinary Isolates: In Need of Increased Vigilance
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Garima Gautam, Sonal Saxena, Ravinder Kaur, Sanjib Gogoi, and Megh Singh Dhakad
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0301 basic medicine ,disk diffusion ,Veterinary medicine ,medicine.drug_class ,030106 microbiology ,Antibiotics ,Cefazolin ,Ceftazidime ,nitrofurantoin ,antimicrobial susceptibility ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ampicillin ,medicine ,030212 general & internal medicine ,business.industry ,Antimicrobial ,gram-negative bacteria ,Mueller-Hinton agar ,Multiple drug resistance ,chemistry ,Nitrofurantoin ,Medicine ,Original Article ,business ,medicine.drug - Abstract
Nitrofurantoin is the first-line drug in the treatment of uncomplicated urinary tract infections (UTIs) and its use has increased exponentially in recent years. Objectives This study aims to determine the susceptibility pattern of nitrofurantoin in gram-negative urinary isolates and to evaluate their bacteriological and epidemiological profile along with co-existing resistance to other important urinary antimicrobials. Material and Methods This was a retrospective study conducted in a tertiary care hospital in New Delhi in which 500 gram-negative bacterial urinary isolates were evaluated. Records of antimicrobial susceptibility were reviewed from July to September 2019. Antimicrobial susceptibility was performed using the Kirby–Bauer disk diffusion method on Mueller Hinton agar and interpreted using CLSI 2019. Test for extended spectrum β-lactamase (ESBL) producers was done using double disk approximation test. Statistical Analysis Data analysis was performed using the SPSS windows version 25.0 software. Results Out of total 500 isolates, 20.17% (94) isolates were resistant (R) to nitrofurantoin and 9.01% (42) were found to be intermediate (I). Highest resistance was seen in Klebsiella sp. (44.61%) and Escherichia coli (8.12%). About 28.82% of the I/R isolates were of the pediatrics age group and most of the isolates belonged to females (64.69%). High resistance was also seen against ampicillin (92.30%), cefazolin (88.46%), ceftazidime (73.0%), and fluoroquinolones (65.38%). Carbapenemase co-resistance was seen in 57.15% isolates whereas ESBL production was seen in 30.76% of E. coli and 12.06% of Klebsiella sp. Conclusion Increase in multidrug resistance uropathogens along with a near absence of novel oral antibiotics has led to increased consumption of nitrofurantoin since its resistance has increased.
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- 2021
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31. A prospective randomized study to define the role of low dose continuous prophylactic antibiotics and anti-adherence agents in altering the microbial colonization related to indwelling double‐J stents
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M.S. Ansari, Kumar Madhavan, Aneesh Srivastava, Rahul Jena, Rakesh Kapoor, Uday Pratap Singh, Sanchit Rustagi, and Sanjoy Kumar Sureka
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medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Urinary system ,Antibiotics ,030232 urology & nephrology ,Urine ,Gastroenterology ,Group B ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Stent ,medicine ,Cranberry ,Clinical significance ,Antibiotic prophylaxis ,Prophylaxis ,business.industry ,Antibiotic ,Diseases of the genitourinary system. Urology ,Nitrofurantoin ,030220 oncology & carcinogenesis ,Original Article ,RC870-923 ,Infection ,business ,medicine.drug - Abstract
Objective Despite conflicting evidence, it is common practice to use continuous antibiotic prophylaxis (CAP) in patients with indwelling double-J (DJ) stents. Cranberry extracts and d -mannose have been shown to prevent colonization of the urinary tract. We evaluated their role in this setting. Methods We conducted a prospective randomized study to evaluate patients with indwelling DJ stents following urological procedures. They were randomized into three groups. Group A (n=46) received CAP (nitrofurantoin 100 mg once daily [OD]). Group B (n=48) received cranberry extract 300 mg and d -mannose 600 mg twice daily (BD). Group C (n=40) received no prophylaxis. The stents were removed between 15 days and 45 days after surgery. Three groups were compared in terms of colonization of stent and urine, stent related symptoms and febrile urinary tract infections (UTIs) during the period of indwelling stent and until 1 week after removal. Results In Group A, 9 (19.5%) patients had significant bacterial growth on the stents. This was 8 (16.7%) in the Group B and 5 (12.5%) in Group C (p-value: 0.743). However, the culture positivity rate of urine specimens showed a significant difference (p-value: 0.023) with Group B showing least colonization of urine compared to groups A and C. There was no statistically significant difference in the frequency of stent related symptoms (p-value: 0.242) or febrile UTIs (p-value: 0.399) among the groups. Conclusion Prophylactic agents have no role in altering bacterial growth on temporary indwelling DJ stent, stent related symptoms or febrile UTIs. Cranberry extract may reduce the colonization of urinary tract, but its clinical significance needs further evaluation.
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- 2021
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32. Prevalence of Urinary Tract Infection and Drug Resistance among Infants and Children in Pakistan
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Qurban Ali, Muhammad Hafeez, Yousma Javed, Muhammad Ayub, Muhammad Asim Rana, Maisam Ali Shahid, Sobia Alyas, Muhammad Sohail, Qasir Akram, and Kumail Sajjad
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medicine.medical_specialty ,biology ,business.industry ,medicine.drug_class ,Antibiotics ,Drug resistance ,bacterial infections and mycoses ,biology.organism_classification ,Ciprofloxacin ,Antibiotic resistance ,Enterococcus ,Amikacin ,Nitrofurantoin ,Internal medicine ,Ampicillin ,Medicine ,business ,medicine.drug - Abstract
In infancy most common and a serious disease is known as Urinary tract infection (UTI). The aim of the current study is to evaluate the frequency and antibiotic resistant among infant presenting with UTI in Lahore General hospital, Lahore-Pakistan. The current observational study comprised 100 (n=100) cases diagnosed with UTI. The study was conducted at Lahore General Hospital, Pakistan, between March 2019 and January 2020. Data were collected and recorded on specified proformas that had information on demographics, biochemical analysis, and complaints, as well as the antibiotic used and blood cultures. The most common gram-negative bacilli (GNB) causing UTI was E. coli constitute about 72% followed by Klebsiella (11%), Enterobacter (7%) and Enterococcus (4%). Most of the isolated pathogens are highly resistant to ampicillin, cotrimoxazole, and cephalexin (72%–95%), have intermediate sensitivity to third- generation cephalosporins, and high sensitivity to amikacin, nitrofurantoin and ciprofloxacin. Similarly, the other pathogens showed different degree of occurrence and resistance against empirically used antibiotics. The most prevalent UTI causative organism among children was E. coli. The insulated microorganisms were highly resistant to ampicillin, and highly sensitive to amikacin.
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- 2021
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33. Antimicrobial Resistance Trends in Urine Escherichia coli Isolates From Adult and Adolescent Females in the United States From 2011 to 2019: Rising ESBL Strains and Impact on Patient Management
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Ashish V Joshi, Aruni Mulgirigama, Nicole E. Scangarella-Oman, Fanny S Mitrani-Gold, Keith S Kaye, Vikas Gupta, Gang Ye, and Kalvin Yu
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Adult ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,Prevalence ,Microbial Sensitivity Tests ,Urine ,medicine.disease_cause ,beta-Lactamases ,Antibiotic resistance ,Internal medicine ,Drug Resistance, Bacterial ,Escherichia coli ,medicine ,Humans ,antimicrobial resistance ,Escherichia coli Infections ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Models, Theoretical ,United States ,Confidence interval ,Anti-Bacterial Agents ,Patient management ,Major Articles and Commentaries ,antimicrobial stewardship ,AcademicSubjects/MED00290 ,Infectious Diseases ,Nitrofurantoin ,Urinary Tract Infections ,uncomplicated urinary tract infection ,Female ,business ,medicine.drug - Abstract
Background Uncomplicated urinary tract infection (uUTI) is predominantly caused by Escherichia coli, which has increasing antimicrobial resistance (AMR) at the United States (US)-community level. As uUTI is often treated empirically, assessing AMR is challenging, and there are limited contemporary data characterizing period prevalence in the US. Methods This was a retrospective study of AMR using Becton, Dickinson and Company Insights Research Database (Franklin Lakes, New Jersey, US) data collected 2011–2019. Thirty-day, nonduplicate Escherichia coli urine isolates from US female outpatients (aged ≥12 years) were included. Isolates were evaluated for nonsusceptibility (intermediate/resistant) to trimethoprim-sulfamethoxazole, fluoroquinolones, or nitrofurantoin, and assessed for extended-spectrum β-lactamase production (ESBL+) and for ≥2 or ≥3 drug-resistance phenotypes. Generalized estimating equations were used to model AMR trends over time and by US census region. Results Among 1 513 882 E. coli isolates, the overall prevalence of isolates nonsusceptible to trimethoprim-sulfamethoxazole, fluoroquinolones, and nitrofurantoin was 25.4%, 21.1%, and 3.8%, respectively. Among the isolates, 6.4% were ESBL+, 14.4% had ≥2 drug-resistance phenotypes, and 3.8% had ≥3. Modeling demonstrated a relative average yearly increase of 7.7% (95% confidence interval [CI], 7.2–8.2%) for ESBL+ isolates and 2.7% (95% CI, 2.2–3.2%) for ≥3 drug-phenotypes (both P, This study provides contemporary data on the prevalence and trends of antimicrobial resistance among E. coli isolated from female outpatient urine cultures in the United States, 2011–2019. The prevalence of antimicrobial resistance is high and increasing for key phenotypes.
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- 2021
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34. Antibiotic Stewardship and Postoperative Infections in Urethroplasties
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Katherine C. Cheng, Bradley A. Erickson, Joshua A. Broghammer, Thomas G. Smith, Alex J. Vanni, Bryan B. Voelzke, Lee C. Zhao, Nejd F. Alsikafi, Jeremy B. Myers, Jill C. Buckley, Saatchi Patell, Sunchin Kim, Sean P. Elliott, and Benjamin N. Breyer
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Male ,Multivariate analysis ,medicine.medical_treatment ,Antibiotics ,030232 urology & nephrology ,Urine ,urologic and male genital diseases ,Antimicrobial Stewardship ,0302 clinical medicine ,Risk Factors ,Prospective Studies ,Incidence ,Middle Aged ,Urology & Nephrology ,female genital diseases and pregnancy complications ,Anti-Bacterial Agents ,Infectious Diseases ,Nitrofurantoin ,Indwelling ,030220 oncology & carcinogenesis ,Urinary Tract Infections ,Practice Guidelines as Topic ,Urologic Surgical Procedures ,Antibiotic Stewardship ,Patient Safety ,Infection ,medicine.drug ,Adult ,Urologic Diseases ,medicine.medical_specialty ,Catheters ,medicine.drug_class ,Urology ,Urethroplasty ,Urinary system ,Clinical Sciences ,Renal and urogenital ,Risk Assessment ,Perioperative Care ,03 medical and health sciences ,Urethra ,Clinical Research ,medicine ,Humans ,Surgical Wound Infection ,Reconstructive Surgical Procedures ,Aged ,Urethral Stricture ,business.industry ,Perioperative ,Plastic Surgery Procedures ,Surgery ,business ,Follow-Up Studies - Abstract
Objective To determine surgical site infection and urinary tract infection (UTI) rates in the setting of urethroplasty. Given significant variation in the utilization of antibiotics, there is an opportunity to improve antibiotic stewardship. This study aims to elucidate the rate of both UTI and surgical site infection after urethroplasty on a standardized perioperative antibiotic regimen, and to obtain patient and operative characteristics that may predict infection. Methods We prospectively treated 390 patients undergoing urethroplasty at 11 centers with a standardized perioperative antibiotic protocol. Patients had a urine culture or urine analysis within 3 weeks of surgery. After surgery, patients were discharged with an indwelling catheter, removed per usual surgeon practice. All were given nitrofurantoin from discharge until catheter removal. Logistic regression analyses were performed to determine the correlation between patient characteristics or operative categories with post-operative infection. Results The rates of postoperative UTI and wound infection within 30 days were 6.7% and 4.1%, respectively. On multivariate analysis of demographics, comorbidities, and stricture characteristics and repair, only preoperative UTI (P = .012), history of cardiovascular disease (P = .015), and performing a membranous urethroplasty (0.018) were significant predictors of a UTI within 30 days postoperatively. Location of repair nor graft use increased the risk of UTI. There were no factors predictive of postoperative wound infection. Conclusion A standardized antibiotic protocol was created to narrow and limit excess antibiotic use. This protocol, with clear definitions of UTI and wound infection, allowed determination of accurate infection rates in urethroplasties. Preoperative UTI, even when properly treated, increases the risk of postoperative UTI.
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35. Purple urine bag syndrome is a rare manifestation of bacteriuria on bladder catheter: case report
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Othmane Mohib, Thomas Roland, Margot Fontaine, France Laurent, and Camelia Rossi
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medicine.medical_specialty ,Urology ,Bladder ,Urine ,Bacteriuria ,03 medical and health sciences ,0302 clinical medicine ,Purple urine bag syndrome ,medicine ,Medical history ,030212 general & internal medicine ,Bag ,medicine.diagnostic_test ,business.industry ,Purple ,Catheterisation ,Rectal examination ,medicine.disease ,Diseases of the genitourinary system. Urology ,Surgery ,Catheter ,Nitrofurantoin ,030220 oncology & carcinogenesis ,RC870-923 ,Purple urine ,medicine.symptom ,business ,Infection ,medicine.drug - Abstract
Background Purple urine bag syndrome (PUBS) is a complication of bacterial colonisation of bladder catheters in which urine turns purple in the tubing, as well as in the catheter bag. This rare phenomenon can be very worrisome and stressful for the patients and their families, as well as for the healthcare team taking care of them. Recognising this complication is essential in order to avoid misdiagnosis and erroneous treatment. We report a case of PUBS in a 71-year-old female patient. Case presentation A 71-year-old woman with previous medical history of schizophrenia was admitted to the emergency department for anorexia and suspicion of psychotic decompensation. Acute urine retention and rectal faecal impaction were clinically suspected and confirmed by bladder ultrasound and rectal examination, respectively. The patient underwent bladder catheterisation as well as a rectal enema. The day after her admission, our medical team was approached by the nurse in charge of the patient because of purple urine in her catheter bag and tubing. The diagnosis of PUBS was made with the help of the Oxford urine chart. A dipstick urinalysis revealed alkaline urine (pH = 8), and the urine culture was subsequently positive for Proteus mirabilis, which is sensitive to quinolones, beta-lactams and nitrofurantoin. The bladder catheter was changed. The patient received empiric antibiotic therapy with Levofloxacin 500 mg once daily. After obtaining the antibiogram, the targeted antibiotic therapy was adapted with oral Cefuroxime 500 mg three times a day for a total duration of seven days of antibiotic therapy. There was no recurrence of purple urine. Conclusion PUBS is a rare complication of bacteriuria, which induces a purple colouration of the tubing as well as the catheter bag. It is a simple spot diagnosis, as there is no other known cause of purple urine. This is why we believe that the Oxford urine chart represents a very interesting and easily accessible tool to help clinicians to investigate any abnormal urine colour.
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- 2021
36. Antibiogram Profiles of Bacteria Isolated from Different Body Site Infections Among Patients Admitted to GAMBY Teaching General Hospital, Northwest Ethiopia
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Misrak Neway, Aschalew Afework, Melkayehu Kassa, Litegebew Yitayeh, Mulugeta Kibret, Wondemagegn Mulu, and Addisu Gize
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0301 basic medicine ,Veterinary medicine ,Klebsiella ,medicine.drug_class ,030106 microbiology ,Antibiotics ,Bahir Dar ,03 medical and health sciences ,0302 clinical medicine ,GAMBY ,Ampicillin ,medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Original Research ,Pharmacology ,Staphylococcus saprophyticus ,biology ,business.industry ,bacterial isolates ,Clindamycin ,biology.organism_classification ,Ciprofloxacin ,Penicillin ,Infectious Diseases ,antibiogram ,Infection and Drug Resistance ,Nitrofurantoin ,clinical specimen ,Ethiopia ,business ,medicine.drug - Abstract
Litegebew Yitayeh,1 Addisu Gize,2 Melkayehu Kassa,2 Misrak Neway,1 Aschalew Afework,1 Mulugeta Kibret,3 Wondemagegn Mulu4 1GAMBY Teaching General Hospital, Bahir Dar, Ethiopia; 2Department of Microbiology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia; 4Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Addisu Gize Email addisu.gize@sphmmc.edu.etBackground: Infections with multi-drug resistant (MDR) bacteria are serious threats to many low-income countries associated with overuse and misuse of antibiotics. This study determined the antibiogram profiles of bacteria isolated from different body site infections among patients admitted to GAMBY Teaching General Hospital, Bahir Dar, Northwest Ethiopia.Methods: A hospital-based cross-sectional study was done between November 2015 and May 2018. Various clinical specimens were sampled from patients and analyzed for aerobic bacterial isolation and Kirby–Bauer disk diffusion susceptibility testing. Chi-square test was calculated to see association among variables, and P-value < 0.05 was taken as a cutoff value for statistical significance.Results: From the 716 clinical specimens processed, 134 (18.7%) were culture-positive for aerobic bacterial pathogens. Culture-confirmed positivity was higher in ear discharge (27.3%) and urine (26.3%) samples. The prevalence of infection was significantly highest among females (P = 0.001). Escherichia coli 63 (47.4%) and 10 (7.4%) of Klebsiella spp. from Gram-negative bacteria were the predominant bacterial isolates, while Staphylococcus saprophyticus 17 (12.6%) and S. aureus 14 (10.4%) were from Gram-positive bacteria. Overall, 61.8% of the isolates were found to be MDR. The proportion of MDR among Klebsiella spp., S. aureus and E. coli isolates was 90.9%, 60.9% and 50%, respectively. Gram-positive bacteria demonstrated 20%, 48.6% and 100% of resistance against norfloxacin, ciprofloxacin and clindamycin, respectively. Gram-negative bacteria also revealed from 20% resistance for the antibiotic nitrofurantoin and 100% of resistance for ampicillin and penicillin.Conclusion: Infections with bacterial isolates resistant to the majority of antibiotics are a major issue in the study area. Most of the identified bacteria were resistant to the routinely used antibiotics, and MDR isolates are alarmingly high. Therefore, clinicians should practice rational choice of antibiotics and treatment should be guided by antimicrobial susceptibility testing.Keywords: bacterial isolates, antibiogram, clinical specimen, GAMBY, Bahir Dar, Ethiopia
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- 2021
37. Trends in antibiotic resistance for over 700,000 Escherichia coli positive urinary tract infections over six years (2014–2019) from a university teaching hospital
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Andrea Ong, Dave Browning, Nitin Mahobia, Bhaskar K. Somani, and Matthew Schembri
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medicine.medical_specialty ,Original Paper ,antibiotic resistance ,business.industry ,antibiotic microbial resistance ,General Medicine ,Amoxicillin ,Fosfomycin ,Trimethoprim ,antibiotics ,Ciprofloxacin ,sepsis ,Pivmecillinam ,chemistry.chemical_compound ,Antibiotic resistance ,chemistry ,Amikacin ,Nitrofurantoin ,Internal medicine ,E. Coli ,medicine ,urinary tract infections ,business ,medicine.drug - Abstract
Introduction Antibiotic microbial resistance (AMR) is a global health problem. Our aim was to review the resistance of Escherichia (E.coli) to antibiotics at our university hospital over a six-year period and see whether our protocol based antibiotic policy over this time led to any change in the resistance patterns. Material and methods Sensitivities of E.coli urine isolates between 2014-2019 (6-years) were sourced from the hospital and general practitioners in the community and collected from the microbiology department. Trends of resistance for amoxicillin, tazocin, cefalexin, ciprofloxacin, co-amoxiclav, gentamicin, nitrofurantoin, trimethoprim, amikacin, and pivmecillinam were examined using the Cochran-Armitage test. Results 712,004 urine samples tested positive for E. coli. The overall resistance trends for cefalexin, nitrofurantoin and amikacin remained equivocal; increased for ciprofloxacin, co-amoxiclav, gentamicin, and tazocin; and decreased for fosfomycin, pivmecillinam, and trimethoprim. Conclusions Despite our protocol based antibiotic policy, although the overall antibiotic resistance remained stable, there was an increasing trend in antibiotic resistance for more commonly used antibiotics including ciprofloxacin, co-amoxiclav, gentamicin, and tazocin reflecting their overall use for prophylaxis and treatment. We plan to continue our policy of reviewing our antibiotic usage and the prescribing protocol with the microbiology department to minimize antibiotic resistance.
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- 2021
38. Fosfomycin versus Nitrofurantoin for the Treatment of Lower UTI in Outpatients
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Umesh Varshney, Rajesh Kumar Singh, Vinita Rawat, Shraddha Sharma, and Pankaj Verma
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medicine.medical_specialty ,Oral treatment ,food.ingredient ,Urinary system ,UTI ,030232 urology & nephrology ,Agar Dilution Method ,Signs and symptoms ,Urine ,nitrofurantoin ,Fosfomycin ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,food ,Internal medicine ,medicine ,Agar ,030212 general & internal medicine ,fosfomycin ,business.industry ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,female genital diseases and pregnancy complications ,Nitrofurantoin ,Medicine ,Original Article ,business ,medicine.drug - Abstract
Introduction Fosfomycin and nitrofurantoin are increasingly being prescribed in outpatients for the oral treatment of urinary tract infection (UTI). Although ample literature is available on the in vitro sensitivity pattern of fosfomycin and nitrofurantoin in UTI cases, clinical data are scant. Methodology Voided midstream urine, collected from patients ≥ 16 years of age of both genders with suspected sign and symptoms, was plated on cystine lactose electrolyte-deficient agar. Uropathogen was defined as an organism known to be associated with the signs and symptoms of UTI with > 105 colony forming units/mL of urine. Antimicrobial susceptibility testing was determined by Kirby-Bauer disc diffusion method. Further, for fosfomycin, agar dilution method was also performed. Results A total of 143 patients, 47 treated with fosfomycin and 96 with nitrofurantoin, were followed for clinical outcome. The most common isolated uropathogen was Escherichia coli. In vitro susceptibility rate of uropathogens against fosfomycin and nitrofurantoin was 99.3% and 81.2%, respectively. Overall, the clinical cure rate with fosfomycin and nitrofurantoin treatment groups was 80.85% and 90.06% respectively (not statistically significant). Conclusion Fosfomycin and nitrofurantoin showed good in vitro activity against uropathogens from lower UTI and can be used for empirical therapy in our area. Multiple confounding factors may have contributed to the discrepancy between in vitro susceptibility and clinical cure, which needs to be studied further.
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- 2021
39. Antimicrobial resistance and antibiotic consumption in a third level pediatric hospital in Mexico City
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Iván de Jesús Ascencio-Montiel, José Guillermo Vázquez-Rosales, Roberto Joaquín Robles-Ramírez, Rodolfo Del Campo-Ortega, Rafael Arias-Flores, and David Abraham Rosado-Rosado
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medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Pharmacy ,Microbial Sensitivity Tests ,Microbiology ,Antimicrobial Stewardship ,Antibiotic resistance ,Virology ,Internal medicine ,Pediatric hospital ,Drug Resistance, Bacterial ,medicine ,Humans ,Child ,Mexico ,business.industry ,cons ,Clindamycin ,General Medicine ,Hospitals, Pediatric ,Anti-Bacterial Agents ,Cross-Sectional Studies ,Infectious Diseases ,Amikacin ,Nitrofurantoin ,Parasitology ,business ,medicine.drug - Abstract
Introduction: The increasing resistance to antibiotics is a public health problem and an imminent therapeutic challenge in hospitals. In this report we aimed to analyze the relationship between antimicrobial resistance and antibiotic consumption in a third-level pediatric hospital. Methodology: A cross-sectional analysis was conducted using the information from the microbiology and pharmacy databases of the Pediatric Hospital “Doctor Silvestre Frenk Freund”, during the period 2015-2018. Prevalence of antimicrobial resistance by microorganisms and dispensed grams of selected antibiotics were calculated annually. Antibiotic resistance trend over the time was evaluated using the Chi-square trends test and to assess the correlation between the dispensed grams of antibiotics with their antimicrobial resistance prevalence, we calculated the Pearson's coefficient (r). Results: A total of 4,327 isolated bacterial samples were analyzed (56.5% Gram-positive and 44.5% Gram-negative). Most frequently isolated microorganisms were coagulase-negative staphylococci (CoNS), E. coli, K. pneumoniae, P. aeruginosa and S. aureus. We found a significant increase in resistance to clindamycin and oxacillin for CoNS and significant decrease in nitrofurantoin and amikacin resistance for E. coli and K. pneumoniae. We observed a strong positive and statistically significant correlation between amikacin resistance prevalence and amikacin dispensed grams for P. aeruginosa (r = 0.95, p = 0.05). Conclusions: The antibiotic resistance profile showed by our study highlights the need of an appropriate antibiotic control use in the Hospital setting.
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- 2021
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40. NOSOCOMIAL URINARY TRACT INFECTIONS, AND THEIR SUSCEPTIBILITY TO ANTIMICROBIAL AGENTS IN SPINAL CORD INJURY PATIENTS AT A REHABILITATION SETTING
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Amir Waheed Butt, Syed Ali Raza Ali Shah, and Syeda Sarah Naqvi
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Medicine (General) ,medicine.medical_specialty ,business.industry ,Urinary system ,Bacteriuria ,medicine.disease ,spinal cord injury ,Ciprofloxacin ,R5-920 ,Amikacin ,Nitrofurantoin ,Internal medicine ,Ceftriaxone ,Medicine ,Gentamicin ,urinary tract infections ,antibiotic susceptibility ,business ,Spinal cord injury ,medicine.drug - Abstract
Objective: To identify frequency of nosocomial urinary tract infections along with their antibiotic susceptibility in spinal cord injury patients. Study Design: Cross-sectional study. Place and Duration of Study: Acute Spinal Ward, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan, from Apr to Oct 2016. Methodology: Total 120 male and female patients of ages (18-70 years) with acute (>6 months) or chronic (>6 months) spinal cord injury admitted for rehabilitation and developing urinary tract infection 48 hours after admissionwere included. Patients whose culture results have polymicrobic bacteriuria samples, immune deficiency disorder and immunosuppressive therapy were excluded. Urine samples of all admitted patients suspected having urinary tract infections were collected and send to Armed Forces Institute of Pathology for culture sensitivity test showing isolated causative microorganisms and their antibiotics susceptibility. Results: About 34.58 ± 12.59 years was mean age, 120 patients were included. In these were 97 (80.80%) male and 23 (19.20%) females with male to female ratio of 4.2:1. Frequency of nosocomial urinary tract infections was found in 83 (69.17%) and no nosocomial urinary tract infections in 37 (30.83%) patients. This study shows the frequency of antibiotic susceptibility in spinal cord injury patients as follows; Amikacin in 111 (92.50%), Gentamicin in 108 (90%), Imipenemin 113 (94.17%), Tazocin in 115 (95.83%), Ceftriaxone in 105 (87.50%), Nitrofurantoin in 89 (74.17%) and Ciprofloxacin in 96 (80.0%) patients. Conclusion: This study shows that frequency of nosocomial urinary tract infections in spinal cord injury patients is high and tazocin and imipenem are the most sensitive antibiotics.
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- 2021
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41. Antibiotics Susceptibility Pattern in Diabetic Ulcer Patients
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Rahmiati Rahmiati, Mita Rahma Yani, Noor Muthmainah, Dewi Indah Noviana Pratiwi, and Alfi Yasmina
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medicine.medical_specialty ,medicine.drug_class ,business.industry ,Antibiotics ,Tigecycline ,bacterial infections and mycoses ,medicine.disease ,Meropenem ,chemistry.chemical_compound ,chemistry ,Nitrofurantoin ,Amikacin ,Internal medicine ,Linezolid ,medicine ,General Earth and Planetary Sciences ,Klebsiella pneumonia ,business ,Ertapenem ,General Environmental Science ,medicine.drug - Abstract
Diabetic ulcers are a chronic complication of diabetes mellitus and have a high risk of infection. Severe ulcer infectionsare a significant cause of lower-extremity amputations in addition to trauma. Therefore, therapy for diabetic ulcer infectionsmust be performed immediately. This study aimed to determine the bacterial susceptibility pattern to the antibiotic indiabetic ulcer patients. This study was retrospective observational descriptive by taking the results of swab culture andantibiotic susceptibility patterns data in diabetic ulcer patients at Ulin General Hospital, Banjarmasin, in 2016-2018. Theresults showed 41 (62.1%) monomicrobial infections and 25 (37.9%) polymicrobial infections. The number of Gram-negativebacilli (57.4%) was higher than Gram-positive cocci (42.6%). The most common bacterial isolates on pus culture wereStaphylococcus aureus (26.6%), Klebsiella pneumonia (19.1%), and Escherichia coli (12.8%). Antibiotic susceptibility testresults showed that Gram-positive bacteria were sensitive to Tigecycline (100%), Nitrofurantoin (96.9%), and Linezolid(96.8%). Gram-negative bacteria were susceptible to Ertapenem (92.7%), Meropenem, and Amikacin (90.6%). S.aureusisolates were sensitive 100% to Meropenem and Tigecycline. K.peneumoniae and E.coli isolates were susceptible 100% toMeropenem and Amikacin. It was concluded in this study that the prevalence of Gram-negative bacteria in diabetic ulcerinfection was higher than Gram-positive bacteria. The most common isolated Gram-negative bacteria were K.pneumoniaeand E.coli, while the most common Gram-positive bacteria were S.aureus. The most sensitive antibiotics for K.pneumoniaeand E.coli were Meropenem and Amikacin, while the most sensitive antibiotics for S.aureus were Linezolid and Tigecycline.
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- 2021
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42. Antibiotics Susceptibility Pattern of MRSA at Intensive Care Room of Ulin General Hospital Banjarmasin
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Noor Muthmainnah, Alfi Yasmina, Shania Indah Chineko, Dewi Indah Noviana Pratiwi, and Rahmiati Rahmiati
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medicine.medical_specialty ,business.industry ,medicine.drug_class ,medicine.medical_treatment ,Quinupristin ,Antibiotics ,Dalfopristin ,Tigecycline ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,medicine.disease_cause ,Methicillin-resistant Staphylococcus aureus ,chemistry.chemical_compound ,chemistry ,Nitrofurantoin ,Internal medicine ,Intensive care ,Linezolid ,medicine ,General Earth and Planetary Sciences ,business ,General Environmental Science ,medicine.drug - Abstract
Infection caused by Methicillin-Resistant Staphylococcus aureus (MRSA) is a healthcare-associated infection thatreceives the most significant attention worldwide due to its resistance. Administration of precise and rational antibiotics canprevent high MRSA rates in hospitals. This study aimed to determine the antibiotic susceptibility pattern of MRSA at theintensive care room of Ulin General Hospital, Banjarmasin, between 2016 and 2018. This study was an observational analyticstudy by taking the results of culture and antibiotic susceptibility pattern data of the MRSA isolated from patients treated atthe intensive care room retrospectively. The results showed 37 data of patients suffering from MRSA at the intensive careroom in 2016-2018, with a percentage of 23.81%, 25.81%, and 35.19%, respectively. The most common sources of MRSAisolate in this study were sputum (32.39%), blood (29.27%), and pus (16.67%). From 2016 to 2017, there was a decreasedsusceptibility to macrolide antibiotics, aminoglycosides such as Gentamicin, and quinolones such as Moxifloxacin. In 2018,there was an increased susceptibility pattern of some antibiotics compared to the previous period. Antibiotics with thehighest susceptibility in period of 2016-2018 were Linezolid, Quinupristin/Dalfopristin, Tigecycline, Nitrofurantoin, andTrimethoprim/Sulfamethoxazole. Also, the antibiotic with the lowest susceptibility was Tetracycline. It was concluded thatthere had been changes in some antibiotics' susceptibility pattern to MRSA within 2016-2018.
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- 2021
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43. Prevalence of Virulence Genes and Antibiotic Resistance Pattern in Enterococcus Faecalis Isolated from Urinary Tract Infection in Shahrekord, Iran
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Hassan Momtaz, Elahe Tajbakhsh, Roya Jafarzadeh Samani, and Mohsen Kabiri Samani
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Cefotaxime ,biology ,business.industry ,medicine.drug_class ,Biochemistry (medical) ,Antibiotics ,Medicine (miscellaneous) ,Virulence ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,Biochemistry ,Enterococcus faecalis ,Microbiology ,Antibiotic resistance ,Nitrofurantoin ,Amikacin ,medicine ,Vancomycin ,business ,Molecular Biology ,medicine.drug - Abstract
Background This study aims to specify the antimicrobial resistance pattern and virulence genes of Enterococcus faecalis isolated from urinary tract infections in Shahrekord, Iran. Methods Urine samples of 1000 people suspected of having urinary tract infections referred to Shahrekord medical diagnostic laboratories were examined. Biofilm assays were performed by microtiter plate test through reading the OD490. Polymerase Chain Reaction (PCR) was applied to study the virulence factors. Results Enterococcus faecalis was detected in 60 samples. After performing microbiological tests, all samples were positive in the molecular analysis. Strong, moderate and weak biofilm reactions reported 66.67%, 25%, and 8.33% respectively. The most resistance reported to cotrimoxazole, vancomycin and amikacin and the lowest resistance to nitrofurantoin (8.33%) was reported. Statistical analysis with Fisher's exact test showed a statistically significant relationship between biofilm production and resistance to cotrimoxazole, vancomycin and cefotaxime. Prevalence of efe A, ace, gel E, esp, cyl M, agg, cyl A and cyl B in strong biofilm formation isolates was reported 100%, 87.5%, 82%, 62.5%, 55%, 37.5% 25% and 22.5% respectively. There was a significant relationship between the frequency of efa A and strong biofilm reaction. Conclusion The presence of E. faecalis strains resistant to co-trimoxazole and vancomycin and present of some virulence factors is alarming the researchers. Since antibiotic resistance genes are probably transmitted among enterococci, and Staphylococci, controlling infections made by enterococci as well as the appropriate administration of antibiotics could treat the nosocomial infections effectively.
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- 2021
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44. Prevalence of Multidrug Resistant UTI Among People Living with HIV in Northern Tanzania
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Bartholomeo Nicholaus Ngowi, Bruno Sunguya, Ayesiga Herman, Alfred Chacha, Eusebious Maro, Leonard France Rugarabamu, John Bartlett, Emmanuel Balandya, Kien Alfred Mteta, and Blandina Theophil Mmbaga
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0301 basic medicine ,medicine.medical_specialty ,Urinalysis ,030106 microbiology ,Bacteriuria ,Urine ,bacteriuria ,Asymptomatic ,Tanzania ,03 medical and health sciences ,0302 clinical medicine ,multidrug resistance ,Internal medicine ,parasitic diseases ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Original Research ,Pharmacology ,people living with human immunodeficiency virus ,biology ,medicine.diagnostic_test ,bacteria urinary tract infection ,business.industry ,medicine.disease ,biology.organism_classification ,Ciprofloxacin ,Infectious Diseases ,Nitrofurantoin ,Infection and Drug Resistance ,Etiology ,medicine.symptom ,business ,medicine.drug - Abstract
Bartholomeo Nicholaus Ngowi,1 Bruno Sunguya,2 Ayesiga Herman,3 Alfred Chacha,4 Eusebious Maro,5 Leonard France Rugarabamu,1 John Bartlett,6 Emmanuel Balandya,2 Kien Alfred Mteta,1 Blandina Theophil Mmbaga6,7 1Urology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 2School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania; 3General Surgery Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 4Clinical Laboratory Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 5Obstetric and Gynecology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 6Duke University, Durham, NC, USA; 7Kilimanjaro Clinical Research Institute, Moshi, TanzaniaCorrespondence: Bartholomeo Nicholaus NgowiKilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, TanzaniaTel +255 767175560Email baltonnic@yahoo.comBackground: Bacterial urinary tract infection (BUTI) is the commonest urinary tract infection among people living with human immunodeficiency virus (PLHIV). It causes significant morbidity in this vulnerable group. Immunosuppression due to HIV can mask the signs and symptoms of infection leading to asymptomatic disease. There is limited evidence in Tanzania regarding BUTI and PLHIV. This study aimed to determine the prevalence, etiology, risk factors and susceptibility pattern of isolates causing asymptomatic UTI in PLHIV at Kilimanjaro Christian Medical Centre (KCMC).Patients and Methods: This cross-sectional study was conducted from July to September 2020 at Kilimanjaro Christian Medical Centre (KCMC) hospital. A questionnaire was used to collect social demographic data from patients’ files together with necessary information required by this study. Urine samples were obtained from participants for urinalysis and urine culture and sensitivity. Data from 300 adults aged ≥ 18 years were analyzed using Statistical Package for Social Science (SPSS) version 22. Mean or median with their measure of dispersion were calculated for continuous variables. Logistic regression was used to determine associations between variables, where P-value < 0.05 was considered to be significant.Results: Bacteriuria was prevalent in 37 (12.3%) of PLHIV. Positive nitrite in urine was associated with bacteriuria (P = 0.01). Gram-positive bacteria were the most common 25 (67.6%) isolates with high sensitivity to nitrofurantoin (88.2%) followed by gentamycin (69.2%). However, resistance was high against ciprofloxacin (77.8%). Multidrug resistance (MDR) was noted in 17 (45.9%).Conclusion: One in eight of PLHIV attending CTC at KCMC referral hospital in Northern zone of Tanzania have BUTI. Presence of nitrites in urine is an important biomarker associated with BUTI. About two third of the isolates were Gram-positive bacteria, and nearly half of all isolates showed MDR to commonly used antibiotics.Keywords: bacteriuria, bacteria urinary tract infection, people living with human immunodeficiency virus, multidrug resistance, Tanzania
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- 2021
45. A retrospective study on the microbial spectrum and antibiogram of uropathogens in children in a secondary care hospital in Rural Vellore, South India
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Anne George, Sushil John, Shalini Jeyapaul, Cherryl Tryphena, Jasmine Helan, and Rani Diana Sahni
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medicine.medical_specialty ,medicine.drug_class ,Urinary system ,Antibiotics ,Cephalosporin ,030209 endocrinology & metabolism ,Urine ,Cefpodoxime ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,antibiotic susceptibility pattern ,medicine ,030212 general & internal medicine ,business.industry ,Antibiogram ,Retrospective cohort study ,UTI in children ,Nitrofurantoin ,Population study ,Medicine ,Original Article ,business ,medicine.drug - Abstract
Background: Urinary tract infection (UTI) is common among children. Empiric antibiotics have to be started as early as possible or it may lead to an irreversible renal parenchymal damage and renal scarring in children. The objectives were to determine the prevalence and microbial profile of paediatric UTI and to determine the antimicrobial susceptibility pattern. Methodology: This is a retrospective study which looked at urine cultures of children below 15 years that were sent during the study period. Results: Among the total urine cultures sent only 21.2% showed significant growth of organisms. The most common organism isolated was E. coli (75.5%). E. coli was least sensitive to cefpodoxime and co-trimoxazole, whereas highly sensitive to nitrofurantoin. Of the total children who had significant growth, 46% had ESBL. Discussion: The prevalence of culture-proven UTI among children was found to be 21.2%. The most common organism isolated among the study population was E. coli (75.5%) followed by Enterococcus species (19.0%) and Klebsiella species (14.5%). It was also found that E. coli was least sensitive to cefpodoxime (31.6%) and co-trimoxazole (26.3%), moderately to amoxicillin-clavulanate (52.4%), whereas highly sensitive to nitrofurantoin (82.9%). This was similar with the studies done at other secondary care hospitals, in Oman and Oddanchathram, South India. Conclusions: With the increasing resistance, cephalosporins should not be used in treating paediatric UTI, whereas nitrofurantoin can be started as an empiric antibiotic, which can later be changed according to the susceptibility pattern.
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- 2021
46. A Retrospective Study on Antibiotic Microbial Sensitivity in Type II Diabetes Mellitus Patients with Urinary Tract Infections
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Anna Balaji, Sasi Prasad Dondapati, Tejasri Kothinti, Manoja Bayyapureddy, Jyosthna Kothapalli, and Anitha Kuttiappan
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Klebsiella ,medicine.medical_specialty ,biology ,medicine.drug_class ,business.industry ,Antibiotic sensitivity ,Antibiotics ,Urine ,biology.organism_classification ,Enterococcus faecalis ,Enterococcus ,Amikacin ,Nitrofurantoin ,Internal medicine ,medicine ,General Pharmacology, Toxicology and Pharmaceutics ,business ,medicine.drug - Abstract
Objectives: The present study was aimed to observe the antibiotic microbial sensitivity patterns in type II Diabetes Mellitus patients with Urinary tract infections. Methods: A retrospective study was conducted in the Department of Endocrinology and Metabolism at Sri Venkateswara Institute of Medical Sciences, Tirupati during a period of 6 months (July to December 2019). 120 culture urine samples were taken for the study as per inclusion and exclusion criteria. All the data were collected, recorded, tabulated and analysed using Microsoft Excel worksheet (Microsoft Corp, Redmond, WA). Continuous and categorical data were expressed in terms of mean ± Standard deviation (SD) and percentage respectively. Antibiotic microbial sensitivity was expressed in terms of percentage. Results: Out of the total of 120 subjects, the most commonly affected age group was 51- 60 years (33.33%). Here females (55%) dominated males (45%) in number. Most commonly isolated Gram-negative organisms were Escherichia coli (35%) and Enterococcus faecalis (15.8%) whereas Gram-positive organisms were Enterococcus faecalis (17.6%) and Staphylococcus aureus (9.16%). Most of the gram-negative bacteria were having a good sensitivity to amikacin (56.75%) and gram-positive bacteria were mostly sensitive to nitrofurantoin (46%). Conclusion: Escherichia coli was the major isolated micro-organism followed by Enterococcus and Klebsiella. Amikacin showed more sensitivity towards gram-negative organisms, whereas Nitrofurantoin showed more sensitivity towards gram-positive organisms. Most uropathogens isolated in Type II Diabetes mellitus were sensitive to Amikacin. This study enlists certain antibiotics which can be used as firstline agents by the physician while awaiting for urine microscopic culture sensitivity results. Key words: Diabetes Mellitus, Retrospective Study, Urinary Tract Infection, Antibiotic Sensitivity, Gram-Positive Organisms, Gram-Negative Organisms.
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- 2021
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47. Türkiye'nin Doğusunda Üçüncü Basamak Bir Hastanede İdrar Örneklerinden İzole Edilen Escherichia coli Suşlarının Antibiyotiklere Duyarlılıkları
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Mehmet Levent Akbulut and Esra Erdoğan
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medicine.medical_specialty ,Cefotaxime ,business.industry ,Cefepime ,General Medicine ,bacterial infections and mycoses ,Amikacin ,Nitrofurantoin ,Internal medicine ,Ampicillin ,Outpatient clinic ,Medicine ,business ,Cefixime ,Cefuroxime ,medicine.drug - Abstract
Objective: Escherichia coli is the most common cause of urinary tract infections. The increase and spread of resistance to antibiotics is a serious problem in our country as well as in the world. The aim of this study was to determine the antimicrobial susceptibility profiles of E.coli strains that cause urinary tract infection. Method: The antibiotic susceptibilities of 1850 E.coli strains isolated from urine samples of patients who applied to Urology service and outpatient clinics of Malatya Education and Research Hospital, which is a tertiary care hospital in eastern part of Turkey, over the 3 years between July 2016 and July 2019, were evaluated retrospectively from computer records using the Vitek 2.0 Compact automated system (BioMérieux, France). Antibiogram results were classified as susceptible, moderately susceptible and resistant. Result: Of the total 1850 samples, 1300 (70.3%) were female and 550 (29.7%) were male, with a mean age of 52 (18-104) years. 73 (3.9%) of the patients were inpatients and 1777 were outpatients. All the isolated E.coli strains were found to be susceptible to ampicillin 39.2%, amoxicillin-clavulanic acid 67.9%, piperacillin-tazobactam 80.8%, cefuroxime 67.1%, cefotaxime 68.8%, cefixime 67.7%, ceftazidime 71.2%, cefepime 73.9%, ertapeneme 97.9%, imipeneme 99.5%, meropeneme 99.7%, amikacin 89.7%, gentamicin 78.4%, norfloxacine 65.8%, ciprofloxacine 65.9%, nitrofurantoin 94.2% and fosfomycin 96.5%. Resistance rates were higher in inpatients as compared to outpatients. Antibiotic susceptibilities were found to be decreased in different age ranges with increasing age. Conclusion: When selecting the antimicrobial treatment in community-acquired UTIs, considering the antimicrobial resistance data in the region, the choice of cost-effective treatment with high patient compliance and low resistance rates will increase treatment success. It is thought that antibiotic treatment should be determined according to the results of culture antibiograms, especially in nosocomial infections due to high resistance rates.
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- 2021
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48. Urinary Tract Infections are becoming Multi-drug Resistant due to Extended Spectrum Beta-lactamases-producing Klebsiella pneumonia
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Henry Kwadwo Hackman, Bright Kojo Azumah, Reuben Essel Arhin, David Boateng, Blessing Nwosu, and Lawrence Annison
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Carbapenem ,Imipenem ,biology ,business.industry ,medicine.drug_class ,Klebsiella pneumoniae ,Antibiotics ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,Microbiology ,Antibiotic resistance ,Amikacin ,Nitrofurantoin ,polycyclic compounds ,Medicine ,Klebsiella pneumonia ,business ,medicine.drug - Abstract
Introduction: Klebsiella pneumoniae are among the most common cause of urinary tract infections such as cystitis and pyelonephritis. These multi-drug resistant K. pneumoniae are producers of extended spectrum beta-lactamases (ESBL) that are capable of hydrolyzing beta-lactams and non-beta-lactams. This laboratory-based study sought to establish the increase of ESBL-producing K. pneumoniae in multi-drug resistant urinary tract infections and determine the effective antibiotic treatment options. Methods: One hundred and seventy five K. pneumoniae isolates obtained from urine cultures were randomly collected and the combined disc synergy method was used to determine the ESBL-producing K. pneumoniae. The Vitek 2 system (bioMérieux, France) was used to perform antimicrobial susceptibility testing of 17 commonly used antibiotics. The data from the work was collated and statistically analysed using the chi-square test and Mann-Whitney U test. P values < 0.05 were considered significant. Results: Of the 175 K. pneumoniae responsible for urinary tract infections, 73.7% were producing ESBL suggesting that most urinary tract infections caused by K. pneumoniae will be multi-drug resistant. The antimicrobial resistance differences between ESBL-producing and non-ESBL-producing Klebsiella pneumoniae indicated a significance difference with p < 0.05. This study indicated that imipenem and amikacin are the antibiotic of choice for the treatment of multi-drug resistant urinary tract infections caused by ESBL-producing K. pneumoniae. Cephalosporins and nitrofurantoin are suitable for the treatment of urinary tract infections due to non-ESBL-producing K. pneumoniae. Conclusion: This study indicated that imipenem (carbapenem) and amikacin are the antibiotic of choice for the treatment of multi-drug resistant urinary tract infections caused by ESBL-producing K. pneumoniae. The third and fourth generation cephalosporins and nitrofurantoin are suitable for the treatment of urinary tract infections due to non-ESBL-producing K. pneumoniae. Rational use of antibiotics and evidence based antibiotic prescription will help to control the spread of resistance by ESBL-producing K. pneumoniae. There is the need to intensify research in the use of natural products to treat multi-drug resistant urinary tract infections emanating from ESBL-producing K. pneumoniae
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- 2021
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49. Aerobacterial Vaginosis among Women Attending an Infertility Clinic at a Tertiary Care Hospital in Chennai, India and Susceptibility Pattern of Isolates
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Suresh Dhanaraj, Pushpa Innocent D. Joseph, Abigail R. Sopia, B. Ananthi, Allen John Henry, and M. Kalyani
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0301 basic medicine ,medicine.medical_specialty ,030106 microbiology ,nitrofurantoin ,Applied Microbiology and Biotechnology ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,meropenem ,antibiotic susceptibility pattern ,amikacin ,Medicine ,030212 general & internal medicine ,clsi guidelines ,Susceptibility pattern ,business.industry ,Tertiary care hospital ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,QR1-502 ,Infertility clinic ,vaginitis ,Family medicine ,business ,Biotechnology ,imipenem - Abstract
Genital infections and subsequent vaginosis diagnosed through high vaginal swab in women is caused due to fungi or bacteria. The presented study focused on determining the types, numbers and antibacterial susceptibility pattern of aerobic bacteria causing vaginosis in 147 female patients attending infertility centre in Chennai, Tamil Nadu, India. Candida spp. caused 17% of infections with 15.7% of vaginosis caused by E.coli, Klebsiella spp., Acinetobacter spp., Citrobacter spp. and Gram positive cocci – Methicillin Sensitive Staphylococcus aureus (MSSA), Coagulase Negative Staphylococci(CONS), Staphylococcus aureus and Enterococcus spp. causing 12.9% of vaginitis in the study population. A total of 20 different antibiotics – cell wall inhibitors, protein synthesis inhibitors and nucleic acid synthesis inhibitors; were tested to determine the response of bacterial isolates by Kirby-Bauer disc diffusion method. The study result determined that the most effective drug for treating Gram positive bacterial vaginitis as per CLSI guidelines based on susceptibility pattern as: Linezolid(100%), Gentamycin(91.6%), Amikacin(87.5%),Erythromycin(79.2%), Co-Trimoxazole(72.2%), Ciprofloxacin(65.6%) and least Chloramphenicol(44.3%). High level gentamycin(83.3%) was found to be effective in treating Enterococci. The descending order of susceptibility of Gram negative aerobacteria causing vaginitis as per CLSI guidelines are: Amikacin(87.5%), Gentamycin(82.5%), Cefoperazone sulbactam (76.3%), Ciprofloxacin(68.5%), Ceftazidime(62.5%) and least Amoxyclav(25%).All Gram negative bacteria tested were susceptible to– Imipenem and Meropenem as well as Chloramphenicol. Ceftriaxone (87.5%) and Nitrofurantoin(72.3%) among other antibiotics was effective against Gram negative bacteria while all Enterobacteriaceae members were found to be resistant to tetracycline.
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- 2021
50. Antibiograms of uropathogens in obstetric patients
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Shrikrishna Kumar Agrawal, Monika Jindal, and Anju Pungale
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Imipenem ,Pregnancy ,medicine.medical_specialty ,biology ,business.industry ,medicine.drug_class ,Antibiotics ,Acinetobacter ,bacterial infections and mycoses ,Antimicrobial ,biology.organism_classification ,medicine.disease ,medicine.disease_cause ,Enterococcus ,Nitrofurantoin ,Staphylococcus aureus ,Internal medicine ,Medicine ,business ,medicine.drug - Abstract
Background: Urinary tract infections (UTI) are the most commonly encountered infections inobstetric patients. Aim: The current study was undertaken to find the spectrum of micro-organismsresponsible for causing UTI in obstetric patients and to find out the most appropriate antibiotic.Materials and Methods: Consecutive patients in different stages of pregnancy with or withoutsymptoms of UTI attending the antenatal clinic from June 2019 to November 2020 were screenedfor significant bacteriuria. The bacterial uropathogens isolated were then subjected to antimicrobialsusceptibility testing and screened for ESBL production and methicillin resistance. Results: Duringthe 18-month study period, out of the 110 samples screened, a total of 66 (60%) samples of urinefrom pregnant females, in different stages of pregnancy were found to be positive on culture. TheEnterobacteriaceae accounted for nearly 69.69% of the isolates and E. coli alone accounted for42.42% of the urinary isolates followed by Acinetobacter 19.69%. Among the Gram-positive cocci,Enterococcus 25.75% were more frequently isolated than Staphylococcus aureus (4.54%).Significantly high resistance was noted to the beta-lactam group of antimicrobials, fluoroquinolonesand cotrimoxazole, both by the Gram-negative bacilli as well as Gram-positive cocci. Resistance wasquite low against the aminoglycosides and nitrofurantoin and virtually absent against imipenem.Conclusion: The susceptibility patterns seen in our study seem to suggest that it is necessary toobtain sensitivity reports before initiation of antibiotic therapy in cases of suspected UTI.
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- 2021
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