Microbiology and Drug Resistance of Pathogens in Patients Hospitalized at the Nephrology Department in the South of Poland

Abstract

A b s t r a c t A retrospective study was conducted among 498 patients with urinary tract infections (UTI) referred to our department from January 2013 to December 2015. This study was performed to evaluate the etiology of UTI and the antibiotic susceptibility profile of Escherichia coli (E. coli) as the main etiological factor in different age groups. Urine samples were examined using standard microbiological methods. Three hundred sixty-three samples (72.9%) were identified as E. coli, of which 29 (8.0%) can produce extended-spectrum β-lactamases (ESBL). E. coli was highly sensitive to imipenem (100.0%), gentamicin (91.0%), nitrofurantoin (89.4%), amikacin (88.2%), piperacillin/ tazobactam (87.0%) and cephalosporins (79.7-89.5%). Low sensitivity was found in relation to fluoroquinolones (60.3-70.4%). E. coli was least sensitive to ampicillin (30.2%) and amoxicillin/clavulanic acid (49.9%). We observed a significant fall in susceptibility level to piperacillin/tazobactam (68.4% vs. 88.8%; p = 0.017), amikacin (61.1% vs. 90.7%; p = 0.001), gentamicin (70.0% vs. 93.2%; p = 0.002), cefalexin (41.2% vs. 83.3%; p < 0.001), cefotaxime (63.6% vs. 89.4%; p = 0.002), ceftazidime (61.9% vs. 85.6%; p = 0.008), cefepime (73.7% vs. 91.1%; p = 0.025), ciprofloxacin (54.1% vs. 72.2%; p = 0.024) and norfloxacin (40.5% vs. 62.5%; p = 0.011) among patients with catheter-associated UTI (CAUTI) compared to those with non-CAUTI. A similar susceptibility profile was observed between different age groups. In the longevity, E. coli showed a higher sensitivity to cephalosporins than in the young-old group. E. coli susceptibility to fluoroquinolones was low, which excludes them as a first-line drug in our department. Nitrofurantoin may be used as an alternative drug to carbapenems. Monitoring of susceptibility pattern is of great importance.

<p>Comparative study of antimicrobial resistance and biofilm formation among Gram-positive uropathogens isolated from community-acquired urinary tract infections and catheter-associated urinary tract infections</p>

“…Multi-drug resistance was much higher in CA-UTI in comparison with Com-UTI. The finding is similar to the study done by Bardoloi et al in Kerala, India26 and Michno et al in Poland 31. The result suggests that catheterization increases the degree of drug resistance in bacteria.…”

Antibiotic Resistance of Uropathogens Isolated from Patients Hospitalized in District Hospital in Central Poland in 2020

“…In our study, a high percentage of K. pneumoniae (81.0%) and P. mirabilis (83.3%) showed resistance to ciprofloxacin. On the other hand, among E. coli isolates, a lower percentage (28.6%) was resistant to this antibiotic, which is in line with the results of earlier study conducted in Poland, in which resistance to fluoroquinolones was found in about 30% of E. coli [ 33 ]. Levels of resistance to aminoglycosides (amikacin—9.7% and gentamicin—24.6%) of E. coli in our study was similar to that obtained in Turkey, but in our study, the percentage of K. pneumoniae and P. mirabilis resistant to gentamicin was lower (19.0% and 40.0%, respectively) than in Turkey (41.6% and 50%, respectively) [ 18 ].…”

Clinical, etiological and antimicrobial susceptibility profile of pediatric urinary tract infections in a tertiary care hospital of Nepal

“…MDR, XDR and MRSA and VRE were noted in higher numbers in case of catheter aspirated urine as compared to clean catch and nappy pad method. Several studies have suggested that isolates obtained from catheterized patient are highly resistant [42, 43]. Previous hospitalization, long-term broad spectrum antimicrobial therapy, co-morbidity, frequent instrumentation, cross transmission of pathogens in catheterized patients might explain the higher antimicrobial resistance [44].…”