Antimicrobial resistance patterns of uropathogens isolated between 2012 and 2017 from a tertiary hospital in Northern Ethiopia

Tuem, Kald Beshir; Desta, Rahel; Bitew, Helen; Ibrahim, Seid; Hishe, Hailemichael Zeru

doi:10.1016/j.jgar.2019.01.022

Cited by 17 publications

(15 citation statements)

References 8 publications

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“…In this study, the overall resistance rate of Gram-positive isolates was 51%, which is consistent with the studies documented in Ethiopia [44,46]. Among the isolated gram-positive bacteria, Staphylococcus aureus represents high drug resistance.…”

Section: Plos Onesupporting

confidence: 91%

“…This study shows that Gram-negative bacteria (61%) are more common than Gram-positive bacteria (19.3%). Similar findings have been reported in Ethiopia and elsewhere [37][38][39].…”

Section: Plos Onesupporting

confidence: 91%

Section: Plos Onecontrasting

confidence: 65%

“…In this study, the estimated MDR isolates of GNB were 156(61%) which is higher than the study documented in Tigray [38], in Addis Ababa cancer patients [47]. In this study, 22.4% and 4% of the gram-negative isolates were XDR and PDR respectively, which is lower than the study conducted in Dessie [37], and in the Tigray region [38]. The reason for this observed high resistance may be due to the increasing irrational use of antibiotics, the transmission of resistance genes between people and people or /and animals to people, and consumption of animal products that treated antibiotics.…”

Section: Plos Onecontrasting

confidence: 64%

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Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute

et al. 2021

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Background Urinary tract infections (UTIs) are the leading causes of morbidity in the general population, and is the second most common infectious disease after respiratory infections. Appropriate antibiotic therapy is essential to achieving good therapeutic results. Therefore, the purpose of this study was to investigate the profile of pathogens cultured from urinary tract infections and to determine their resistance profiles to commonly prescribed antibiotics. Method A cross-sectional study was carried out at the National Referral Laboratory of the Ethiopian Institute of Public Health from January 2017 to December 2018. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. The antimicrobial susceptibility test of the isolate was performed using the Kirby- Bauer disk diffusion test on Muller-Hinton agar. In addition, bacterial identification, antimicrobial susceptibility testing and phenotypic detection of MDR were performed with VITEK 2 Compact according to the manufacturer’s instructions. Result Out of 1012 cultured urine specimens, 325 (32.1%) was showed significant bacteriuria. The overall prevalence of UTIs was 325(32.1%) and the highest prevalence rate was obtained from 21–30 years age group 73(22.5%). Among UTIs patients, 583(57.6%) were females and 429(42.4%) were males. The UTIs of 179 (55%) women is relatively higher than that of men 146 (45%). Among 325 isolates, Gram-negative bacteria (GNB) appeared more frequently 252 (51.7%) than Gram-positive bacteria 63 (19.4%). In GNB, E. coli 168(66.7%), Klebsiella species 32(12.7%), and Enterobacter species 13 (5.2%) were dominated isolates whereas in GPB accounted for coagulase-negative staphylococcus (CoNS) 33(52.4%), Enterococcus species 16(25.4%), and Staphylococcus aureus 10(15.9%). Major of the isolates showed high levels of antibiotic resistance to commonly prescribed antimicrobials. Imipenem, Amikacin, and Nitrofurantoin were the most sensitive antibiotics for Gram-negative isolates while Nitrofurantoin, clindamycin, and Gentamycin were effective against gram-positive uropathogens. Overall, 156/256(60.9%), 56/256(22.4%), 10/256(4%) of gram-negative isolates were MDR, XDR, and PDR respectively while among the GPB isolates, 34/63(53.1%), 10/63(15.8%), and 1/63(1.6%) were MDR, XDR, and PDR isolates respectively. Among the tested bacterial strains, 190/319 (59.5%) were MDR, 66/319 (20.7%) strains were XDR, and 11/319 (3.45%) were PDR isolated. Conclusion The prevalence of urinary tract infection was high, and Gram-negative organisms were the most common causes of UTIs in this study. It was found that the resistance to commonly used antibiotics is very high. Early detection and close monitoring of MDR, XDR, or even PDR bacterial strains must be started by all clinical microbiology laboratories to reduce the menace of antimicrobial resistance that is now a global problem.

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Section: Plos Onesupporting

confidence: 91%

“…This study shows that Gram-negative bacteria (61%) are more common than Gram-positive bacteria (19.3%). Similar findings have been reported in Ethiopia and elsewhere [37][38][39].…”

Section: Plos Onesupporting

confidence: 91%

Section: Plos Onecontrasting

confidence: 65%

Section: Plos Onecontrasting

confidence: 64%

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Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute

et al. 2021

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“…We found that Escherichia coli was the most prevalent pathogen in both sexes regarding isolated pathogens, which is in line with previous reports [ 1 , 7 , 26 , 28 , 33 , 34 , 35 ]. However, the risk of IHM was associated with Staphylococcus aureus , but the risk decreased with other isolated pathogens, which is also observed among patients with COPD and type 2 diabetes mellitus [ 7 , 27 ].…”

Section: Discussionsupporting

confidence: 93%

Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)

Palacios‐Ceña

Hernández‐Barrera

Fernández‐de‐las‐Peñas

et al. 2021

JCM

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(1) Background: To assess time trends in the incidence and in-hospital outcomes of urinary tract infection (UTI) in older people (≥65 years) in Spain (2001–2018) according to sex and to identify the factors independently associated with in-hospital mortality (IHM). (2) Methods: Using the Spanish National Hospital Database, we analyzed comorbidity, procedures, diagnosis, isolated microorganisms, and outcomes. (3) Results: We included 583,693 admissions (56.76% women). In both sexes, the incidence increased with age over time (p < 0.001). In men and women, the highest IHM was found among the oldest patients (>84 years) with values of 9.16% and 8.6%, respectively. The prevalence of bacteremia increased from 4.61% to 4.98% from 2001 to 2018 (p < 0.001) and sepsis decreased from 3.16% to 1.69% (p < 0.001). The risk of dying increased with age (>84 years) (OR 3.63; 95% CI 3.5–3.78) and with almost all comorbidities. Urinary catheter was a risk factor for women (OR 1.1; 95% CI 1.02–1.18) and protective for men (OR 0.71; 95% CI 0.66–0.76). Isolation of Staphylococcus aureus increased the risk of IHM by 40% among men (OR 1.4; 95% CI 1.28–1.53). After adjusting for confounders, IHM decreased over time. (4) Conclusions: The incidence of UTIs was higher in older patients and increased over time; however, IHM decreased during the same period. Female sex, age, comorbidities, sepsis, and a Staphylococcus aureus isolation increased risk of IHM.

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Unlocking Nitrofurantoin: Understanding Molecular Mechanisms of Action and Resistance in Enterobacterales

Khamari,

Bulagonda

2024

Med Princ Pract

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Antimicrobial resistance (AMR) is a global health crisis that has already claimed millions of lives and is projected to affect millions more unless urgent action is taken. Effective control of AMR requires the correct choice and dosage of antibiotics, as well as robust surveillance and research. Understanding the mechanisms of antibiotic action and the emergence of resistance phenotypes along with their genotypes is essential. This knowledge, combined with insights into resistance prevalence and spread, empowers clinicians to propose alternative therapies. Nitrofurantoin, a 70-year-old antibiotic, remains effective for the treatment of uncomplicated lower UTIs. Preventing emergence and spread of nitrofurantoin resistant superbugs would preserve the efficacy of this antibiotic which is crucial for ongoing and future AMR efforts. Nitrofurantoin resistance evolves slowly, leading to low prevalence compared to other antibiotics. However, it is often linked with extensive drug resistance, complicating treatment outcomes. Even a minor percentage of nitrofurantoin-resistant bacteria can cause significant clinical challenges due to irreversible evolution. While detailed study of these mechanisms can guide the development of strategies to combat nitrofurantoin resistance, early detection of resistant infections is critical for saving lives. The current review aims to provide a comprehensive analysis of nitrofurantoin’s mechanisms of action, resistance evolution, prevalence, and resistance prediction. Our goal is to offer valuable insights for researchers and clinicians to enhance nitrofurantoin use and address the challenges posed by AMR.

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Antimicrobial resistance patterns of uropathogens isolated between 2012 and 2017 from a tertiary hospital in Northern Ethiopia

Cited by 17 publications

References 8 publications

Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute

Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute

Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)

Unlocking Nitrofurantoin: Understanding Molecular Mechanisms of Action and Resistance in Enterobacterales

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