Spectrum and antibiotic resistance in community- and hospital-acquired urinary tract infections among adults: Experience from a large tertiary care center in a developing country

Herbawi, Aya; Abu Taha, Adham; Aiesh, Banan M.; Sabateen, Ali; Zyoud, Sa’ed H.

doi:10.1177/03915603241236361

Cited by 2 publications

(1 citation statement)

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“…Similar to a very recently published study, we found a high rate of ESBL positivity and resistance to other antibiotic classes (fluoroquinolones, sulfonamides, and aminoglycosides) in both community-onset and hospital-acquired UTI cases ( Herbawi et al, 2024 ). Carbapenem resistance was also detected in 11.9% of cases with ESBL positivity.…”

Section: Discussionsupporting

confidence: 90%

Urinary tract infections in older adults: associated factors for extended-spectrum beta-lactamase production

Alkan,

Balkan,

Surme

et al. 2024

Front. Microbiol.

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ObjectiveUrinary tract infections (UTIs) due to extended-spectrum beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae are among the leading causes of morbidity and mortality in older adults. Identifying associated factors for ESBL production may contribute to more appropriate empirical treatment.Materials and methodsThis was a prospective observational study. Hospitalized patients of age > 65 with community-onset or hospital-acquired upper UTI due to E. coli or Klebsiella pneumoniae were included. A multivariate analysis was performed.ResultsA total of 97 patients were included. ESBL prevalence among UTIs with E. coli or Klebsiella pneumoniae was 69.1% (n = 67). CRP values at the time of UTI diagnosis were found to be significantly higher in the ESBL-producing group (p = 0.004). The multivariate analysis revealed that male gender (OR: 2.72, CI: 1.02–7.25), prior recurrent UTI (OR: 3.14, CI: 1.21–8.14), and the development of secondary bacteremia (OR: 4.95, CI: 1.03–23.89) were major associated factors for UTI in older adults due to ESBL-producing E. coli and Klebsiella pneumoniae.ConclusionSevere UTI in older men with a history of recurrent UTI may be a warning to the clinician for ESBL production in the setting of high ESBL prevalence. Carbapenems may be prioritized in the empirical treatment of patients with known risk factors for ESBL.

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Section: Discussionsupporting

confidence: 90%

Urinary tract infections in older adults: associated factors for extended-spectrum beta-lactamase production

Alkan,

Balkan,

Surme

et al. 2024

Front. Microbiol.

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Characteristics and antibiotic resistance patterns of urinary tract isolates in hospitalized and non-hospitalized patients: a cross-sectional study in Khartoum, Sudan

El-Arifi,

AbdAlla,

Mahgoub

et al. 2024

BMC Infect Dis

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Background Urinary tract infections (UTIs) are widespread worldwide impacting society, economics, and healthcare systems. The rise of antibiotic resistance in both hospital and community settings has further complicated UTI management. This study aims to assess the epidemiologic distribution and microbiologic classification of UTI-causing microorganisms, as well as their resistance patterns. Methods This cross-sectional descriptive study was conducted at the National Public Health Laboratories in Khartoum, Sudan. Urine samples were collected from three hospitals from September to December 2021, and 65 bacterial isolates were recovered from patients with clinical symptoms of UTI. Bacterial identification and antimicrobial susceptibility testing were performed using standard bacteriological methods and Kirby-Bauer’s disc diffusion method. Genotyping for Extended Spectrum Beta-Lactamase (EsβL) production was conducted using multiplex PCR. Results Of the 65 bacterial isolates, 27 (41.5%) were community-acquired UTI patients (C-UTIs), and 38 (58.5%) were hospital acquired UTI patients (H-UTIs). Males were more commonly affected by H-UTIs (68.4%), while females represented the majority among C-UTIs (85.2%). Gram-negative bacteria were predominant in urinary isolates (81.54%), with Escherichia coli being the most common organism (49.1%). Gram-positive organisms accounted for 18.46% of isolates, with Enterococcus spp. being the most prevalent. In-vitro susceptibility analysis revealed that meropenem was the most effective antibiotic in Gram-negative isolates (77.4%), while nitrofurantoin was the most effective in Gram-positive isolates (91.67%). EsβL production was detected in 11/23 (47.8%) of the tested isolates with Escherichia coli being the most common ESβL producer. Conclusion This study highlights the pattern of antibiotic-resistant bacteria in UTIs and their significance. Continuous monitoring, development of local antibiograms, and implementation of surveillance programs are essential for guiding empirical antibiotic use and managing UTIs effectively, especially in resource-limited settings like Sudan. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-024-10130-8.

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Spectrum and antibiotic resistance in community- and hospital-acquired urinary tract infections among adults: Experience from a large tertiary care center in a developing country

Cited by 2 publications

References 25 publications

Urinary tract infections in older adults: associated factors for extended-spectrum beta-lactamase production

Urinary tract infections in older adults: associated factors for extended-spectrum beta-lactamase production

Characteristics and antibiotic resistance patterns of urinary tract isolates in hospitalized and non-hospitalized patients: a cross-sectional study in Khartoum, Sudan

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