Antimicrobial Susceptibilities and Clinical Characterization of &lt;b&gt;&lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt;&lt;/b&gt; Isolates from Urinary Tract Infections

Zhang, Xiaobing; Niu, Siqiang; Zhang, Liping

doi:10.1159/000358493

Cited by 11 publications

(11 citation statements)

References 20 publications

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“…A high P. aeruginosa susceptibility rate to amikacin (100%), ceftazidime, cefepime, gentamycin, piperacillin/tazobactam (92%), and imipenem (85%) was reported in the current study which was higher than the frequency reported by Zhang et al 24 Genotyping of 18 E. coli strains causing nosocomial infections depicted the presence of three clusters with more than 70% genetic similarity, 12 of 18 strains were isolated from urology or surgical units. These results suggested the possibility of dissemination of these clones, especially in these two units.…”

Section: Discussioncontrasting

confidence: 77%

<p>Antimicrobial Resistance and Genotyping of Bacteria Isolated from Urinary Tract Infection in Children in an Iranian Referral Hospital</p>

Mamishi¹,

Shalchi²,

Mahmoudi³

et al. 2020

IDR

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Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood, and the increasing rate of antibiotic resistance to the commonly prescribed antimicrobial agents against it has become a major concern. The aim of this study was to determine the antibiotic resistance and genotyping of bacteria isolated from urine cultures in patients referred to the Children's Medical Center, Tehran, Iran. Methods: During the 1-year period, antimicrobial susceptibility profiles of strains isolated from patients with UTI were determined. Typing of the isolates causing nosocomial infections was performed by random amplified polymorphic DNA (RAPD) analysis, and the results were analyzed by Gelcompar II software. Results: In this study, 203 children (130 girls and 73 boys) were included. The patients' age ranged from 1 day to 16 years (IQR average=4 months to 4 years). The most frequent isolated organisms were Escherichia coli (118 isolates, 58%), followed by Klebsiella pneumoniae (30 isolates, 15%). Sixty-two strains (18 strains of E. coli, 13 strains of K. pneumoniae, 11 strains of Enterococcus faecium, and five strains of Burkholderia cepacia complex) had criteria of nosocomial infection. A high resistance rate to trimethoprim-sulfamethoxazole (69%) and cefotaxime (60%) was reported in E. coli and K. pneumoniae strains, respectively. Pseudomonas aeruginosa strains showed high sensitivity to amikacin (100%). All E. faecium strains were susceptible to trimethoprim-sulfamethoxazole (100%), and 23% of the strains were resistant to vancomycin. The analysis of RAPD-typing revealed the presence of three clusters in E. coli, two clusters in E. faecium, and one clone in K. pneumoniae. Besides, four out of five isolates of B. cepacia complex had more than 90% genetic similarity. Conclusion: The most frequent isolated pathogen was E. coli, and an increasing rate of antibiotic resistance to the commonly prescribed antimicrobial agents such as trimethoprim/ sulfamethoxazole and cephalosporins was observed. Moreover, the results of this study showed the presence of clones with ≥80% similarity in E. coli, K. pneumoniae, E. faecium, and B. cepacia complex isolates; therefore, the transmission of nosocomial infections from one patient to another or one ward to another is probable.

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Section: Discussioncontrasting

confidence: 77%

<p>Antimicrobial Resistance and Genotyping of Bacteria Isolated from Urinary Tract Infection in Children in an Iranian Referral Hospital</p>

Mamishi¹,

Shalchi²,

Mahmoudi³

et al. 2020

IDR

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“…is due to the high rate of infection stones, which was similar in the study of Ng et al [11]. The more difficult to treat bacteria such as Pseudomonas aeruginosa or even rarities such as Salmonella typhi may cause treatment failure in primary calculated antibiotic therapy of OPN [14,15]. We agree with van Nieuwkoop et al [16] that imaging is necessary in patients with febrile UTI in the presence of a history of urolithiasis and/or a urine pH ≥7.0 and/or renal insufficiency (estimated glomerular filtration rate ≤40 ml/min/1.73 m 3 ).…”

Section: Discussionmentioning

confidence: 68%

Long-Term Results after Acute Therapy of Obstructive Pyelonephritis

et al. 2015

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Introduction: To evaluate therapeutic results till 5 years after therapy of obstructive pyelonephritis (OPN) emphasizing regular follow-up. Material and Methods: During 5 years, 57 patients with OPN were treated. The patients' charts were reviewed retrospectively for clinical data. These were completed by a questionnaire. Results: In the group of 57 patients (average age 56 years), about two third were women. Urolithiasis (65%) and tumors (21%) were the main causes of obstruction; fever (91%) and loin pain (86%) the main symptoms. Three fourth of the patients showed renal insufficiency and nearly 50% anemia. E. coli and Proteus spp. were the dominating organisms. Sonography detected obstruction in 93% cases. In one third of cases, CT scan was added; 81% percutaneous nephrostomy and 19% ureteral stenting were the initial methods of urinary drainage. During therapy, 23% nephrectomies (19% complete, 4% partial) were performed. Long-term follow-up showed 11% recurrent OPN and 33% recurrent UTI. Conclusions: After diagnosis of OPN, primary nephrostomy or ureteral stenting and antibiotic therapy are the first measures. If recurrent urinary tract infections or OPN occur, long-term follow-up and low-dose antibiotic prophylaxis may be discussed.

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“…6 Any type of surgery (minor to major) or invasive procedure (e.g., endoscopy, percutaneous intervention) in the past 6 months. 7 At least two doses of any antibiotic in the past 3 months preceding HAUTI. 8 Patients with urinary catheter on the day the culture was taken or the day before, including patients with chronic catheters.…”

Section: Resultsmentioning

confidence: 99%

Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections

et al. 2022

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Hospital-acquired urinary tract infection (HAUTI) is one of the most common hospital-acquired infections, and over 80% of HAUTI are catheter-associated (CAUTI). Pseudomonas aeruginosa, as well as other non-glucose fermenting Gram negative organisms (NGFGN, e.g., Acinetobacter baumannii), are frequently covered empirically with “anti-Pseudomonals” being administered for every HAUTI (and CAUTI). However, this common practice was never trialed in controlled settings in order to quantify its efficacy and its potential impacts on hospitalization outcomes. There were 413 patients with HAUTI that were included in this retrospective cohort study (2017–2018), 239 (57.9%) had CAUTI. There were 75 NGFGN infections (18.2% of HAUTI, 22.3% of CAUTI). P. aeruginosa was the most common NGFGN (82%). Despite multiple associations per univariable analysis, recent (3 months) exposure to antibiotics was the only independent predictor for NGFGN HAUTI (OR = 2.4, CI-95% = 1.2–4.8). Patients who received empiric anti-Pseudomonals suffered from worse outcomes, but in multivariable models (one for each outcome), none were independently associated with the empiric administration of anti-Pseudomonals. To conclude, approximately one of every five HAUTI (and CAUTI) are due to NGFGN, which justifies the practice of empiric anti-Pseudomonals for patients with HAUTI (and CAUTI), particularly patients who recently received antibiotics. The practice is not associated with independent deleterious impacts on outcomes.

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Antimicrobial Susceptibilities and Clinical Characterization of <b><i>Pseudomonas aeruginosa</i></b> Isolates from Urinary Tract Infections

Cited by 11 publications

References 20 publications

<p>Antimicrobial Resistance and Genotyping of Bacteria Isolated from Urinary Tract Infection in Children in an Iranian Referral Hospital</p>

<p>Antimicrobial Resistance and Genotyping of Bacteria Isolated from Urinary Tract Infection in Children in an Iranian Referral Hospital</p>

Long-Term Results after Acute Therapy of Obstructive Pyelonephritis

Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections

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