Antibiotic Drug Resistance Pattern of Uropathogens in Pediatric Patients in Pakistani Population

Iqbal, Zakia; Sheikh, Ahsan Sattar; Basheer, Anwaar; Hafsa, Hadiqa tul; Ahmed, Mehboob; Sabri, Anjum Nasim; Shahid, Salman

doi:10.3390/antibiotics12020395

Cited by 4 publications

(5 citation statements)

References 29 publications

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“…The resistance pattern of third generation cephalosporins was higher than those of meropenem and imipenem. These results are consistent with the previous studies [23,24]. The resistance patterns of both groups (ward and OPD) of the isolates showed higher resistance to penicillin, cephalosporins, and quinolones.…”

Section: Discussionsupporting

confidence: 93%

In Vitro Activity of New β-Lactamase Inhibitor Combinations against blaNDM, blaKPC, and ESBL-Producing Enterobacteriales Uropathogens

Razaq,

Uddin,

Ali

et al. 2023

Antibiotics

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Antibiotic resistance in uropathogens has increased substantially and severely affected treatment of urinary tract infections (UTIs). Lately, some new formulations, including meropenem/vaborbactam (MEV), ceftazidime/avibactam (CZA), and ceftolozane/tazobactam (C/T) have been introduced to treat infections caused by drug-resistant pathogens. This study was designed to screen Enterobacteriales isolates from UTI patients and to assess their antimicrobial resistance pattern, particularly against the mentioned (new) antibiotics. Phenotypic screening of extended-spectrum β-lactamase (ESBL) and carbapenem resistance was followed by inhibitor-based assays to detect K. pneumoniae carbapenemase (KPC), metallo-β-lactamase (MBL), and class D oxacillinases (OXA). Among 289 Enterobacteriales, E. coli (66.4%) was the most predominant pathogen, followed by K. pneumoniae (13.8%) and P. mirabilis (8.3%). The isolates showed higher resistance to penicillins and cephalosporins (70–87%) than to non-β-lactam antimicrobials (33.2–41.5%). NDM production was a common feature among carbapenem-resistant (CR) isolates, followed by KPC and OXA. ESBL producers were susceptible to the tested new antibiotics, but NDM-positive isolates appeared resistant to these combinations. KPC-producers showed resistance to only C/T. ESBLs and carbapenemase encoding genes were located on plasmids and most of the genes were successfully transferred to recipient cells. This study revealed that MEV and CZA had significant activity against ESBL and KPC producers.

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Section: Discussionsupporting

confidence: 93%

In Vitro Activity of New β-Lactamase Inhibitor Combinations against blaNDM, blaKPC, and ESBL-Producing Enterobacteriales Uropathogens

Razaq,

Uddin,

Ali

et al. 2023

Antibiotics

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“…Sensitivity to trimethoprim-sulphmethoxazole in our study was 19% only, while in previous studies it was 97 % 16 , 70% 19 , 63% 9 , 50% 2 , 42% 3 , 39% 13 , 26% 7 , and only 6%. 10 Sensitivity to cephalosporin in our study was only 8% which is quiet alarming situation for our geographic area because in previous studies sensitivity to cephalosporins was quite good, i.e., it was 85% to cefoxitin, 82% to cefotaxime, and 75% to ceftazidime in one study 3 while in other studies it was 93 % to ceftriaxone 16 , 74% to cefotaxime 9 and 19.8% to cefixime. 1 Similarly studies conducted in Pakistan previously which shows sensitivity of 32.3%, 39%, 21.3% and only 10% to ceftriaxone 18,1,19,10 whereas sensitivity to cefotaxime 23.8% and 22.5%.…”

Section: Discussioncontrasting

confidence: 55%

“…18 In our study E. coli was 94% sensitive to amikacin whereas in other studies sensitivity to amikacin were 89.5% 19 , 87% 7 , 81%, 2 95.5% 9 , 40.4%, 1 51% 18 , and 63%. 10 In our study sensitivity to cefoperazonesulbactam, piperacillin-tazobactam and Nitrofurantoin was >80%. Other studies in the past also shows the similar results for nitrofurantoin 98%, 85.3%, 82%, 97%, 88%, 83%, and 82%.…”

Section: Discussionsupporting

confidence: 45%

“…Urinary Pathogens having strong ability for invasion, adhesion and virulence along with emerging increased antibiotic resistance is becoming a great concern throughout the world. 10 Although very few studies have shown the status of UTI in general population, larger studies are limited towards specific target population such as HIV patients, diabetic patients, pregnant woman, children and students. 1 Similar situation applies to Pakistan and limited data on UTIs, risk factors, and drug resistance profiles are available from the general population.…”

Section: Introductionmentioning

confidence: 99%

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Antibiogram and susceptibility pattern of bacterial isolates of urinary tract infection among children and adolescents at a tertiary care hospital

Arshad,

Rasheed,

Hussain

et al. 2024

Infect Dis J Pak

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Background: UTI is one of the major causes of morbidity among children and adolescents in developing countries like Pakistan, where precise knowledge of causative micro-organisms and their antimicrobial susceptibility patterns remains inadequate. To identify common organisms involved in urinary tract infection and their antimicrobial sensitivity patterns among children & adolescents. Material and Methods : This retrospective descriptive study was conducted on urine cultures reports of children less than 18 year presented with suspected UTI in Allama Iqbal Memorial Teaching Hospital between the periods of January 2020 to December 2022 were taken. Urine sample cultured on CLED agar plates, micro-organism were identified by performing their morphological & biochemical tests. Results: Urine culture reports of 500 patients of age <18 years with suspected UTI were collected, out of which 102 were positive. The most common age for UTI was 5-11 years. The ratio of boys and girls was 30 and 72 respectively. Both Gram-negative and Gram-positive bacterial species were recovered. The ratio of gram negative to gram positive was 94 and 8 respectively. Among Gram-negative bacterial species, E. coli was the most common organism. Antimicrobial susceptibility pattern of E. coli showed that susceptibility to commonly prescribed drugs as follows Gentamicin (80%), co-amoxiclav (52%), Trimethoprim- Sulfamethoxazole (19%), Cephalosporin’s (8%), and Amoxicillin (5%). Susceptibility to Nitrofurantoin & Fosfomycin was 80% and 63% respectively. Conclusion: E.coli was the most common organism Isolated. Co-amoxiclav, Nitrofurantoin and Fosfomycin have good susceptibility profile among the oral drugs and Gentamicin has high susceptibility among injectables. Keywords: Urinary tract infection, Antibiotic sensitivity, Urine culture

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“…This pattern is in line with a number of research studies conducted in Pakistan in the past decade that showed Enterobacterales’ increasing resistance to the cephalosporin and penicillin class of antibiotics. 14 , 23 - 25 …”

Section: Discissionmentioning

confidence: 99%

Pediatric Uropathogens and their Antimicrobial Susceptibility Pattern: Experience from an Impoverished District of Karachi, Pakistan

Khan,

Shakeel

2024

Clin Med Insights Pediatr

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Introduction: Urinary tract infection (UTI) is the most common infection of the pediatric age group. Several factors linked to higher prevalence include poor personal hygiene, improper sanitation, lower socioeconomic status, and malnourishment. In addition to having a worse quality of life, the 1.8 million children who live in Karachi’s Korangi district are routinely exposed to such factors. Objectives: The study aims to evaluate the frequency of UTI and distribution of uropathogens along with their antimicrobial susceptibility pattern in patients presenting to a pediatric tertiary care center in the Korangi district of Karachi, Pakistan. Design: The study employed an observational cross-sectional design. Methods: The study was conducted at the Microbiology laboratory of Sindh Institute of Child Health and Neonatology, Karachi, Pakistan from 1st January to 15th August 2023. Urine samples of patients 1 to 16 years of age were collected via midstream clean catch method and of patients from birth up to 1 year were collected in urine collection bags. The samples were cultured on Cystine Lactose Electrolyte Deficient (CLED) agar and antibiotic susceptibility testing was performed using the Kirby-Bauer Disc Diffusion method. Results: A total of 457 urine samples were collected, of which 90 (19.7%) were positive for significant uropathogens. With a mean age of 4.6 years, majority of the culture-positive patients were female (n = 72; 80%). Enterobacterales were the most frequently isolated (n = 88; 95.6%), of which Escherichia coli was the most common (73.9%; n = 68). Citrobacter (n = 7; 7.6%), Klebsiella (n = 6; 6.5%), Serratia (n = 4; 4.3%), Proteus (n = 2; 2.2%), Salmonella (n = 2; 2.2%), and Enterobacter (n = 1; 1.1%) were among the other Enterobacterales isolated. Meropenem and imipenem were the most effective in isolates from Enterobacterales (n = 88) followed by amikacin (n = 84), ciprofloxacin (n = 75), and piperacillin-tazobactam (n = 70). Ceftriaxone and cefixime exhibited moderate susceptibility (n = 69 and 52) whereas, amoxicillin-clavulanate was the least susceptible (n = 3). Conclusion: We report high frequency of UTI in our pediatric population with uropathogens and associated antimicrobial susceptibility pattern confirming to the existing trends of pediatric UTIs in Pakistan. In addition to valuable insights for treating patients under similar conditions, our study serves as a catalyst for further multi-center research in this area.

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Antibiotic Drug Resistance Pattern of Uropathogens in Pediatric Patients in Pakistani Population

Cited by 4 publications

References 29 publications

In Vitro Activity of New β-Lactamase Inhibitor Combinations against blaNDM, blaKPC, and ESBL-Producing Enterobacteriales Uropathogens

In Vitro Activity of New β-Lactamase Inhibitor Combinations against blaNDM, blaKPC, and ESBL-Producing Enterobacteriales Uropathogens

Antibiogram and susceptibility pattern of bacterial isolates of urinary tract infection among children and adolescents at a tertiary care hospital

Pediatric Uropathogens and their Antimicrobial Susceptibility Pattern: Experience from an Impoverished District of Karachi, Pakistan

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