Spectrum and patterns of antimicrobial resistance of uropathogens isolated from a sample of hospitalised Lebanese patients with urinary tract infections

Soubra, Lama; Kabbani, Sarah; Anwar, Muneeza; Dbouk, R.

doi:10.1016/j.jgar.2014.01.007

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…As expected, E. coli was the leading species recovered from UTIs regardless the context. Regarding outpatients, E. coli accounted for about 80% of all Enterobacterales isolates collected from urinary tract samples, which was similar to other countries [ 8 , 9 , 10 ]. We found a similar distribution of Enterobacterales species in obstetrics/gynecology, pediatrics, and psychiatry as in outpatients.…”

Section: Discussionsupporting

confidence: 79%

Antimicrobial Resistance in Enterobacterales Recovered from Urinary Tract Infections in France

et al. 2022

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In the context of increasing antimicrobial resistance in Enterobacterales, the management of these UTIs has become challenging. We retrospectively assess the prevalence of antimicrobial resistance in Enterobacterales isolates recovered from urinary tract samples in France, between 1 September 2017, to 31 August 2018. Twenty-six French clinical laboratories provided the susceptibility of 134,162 Enterobacterales isolates to 17 antimicrobials. The most frequent species were E. coli (72.0%), Klebsiella pneumoniae (9.7%), Proteus mirabilis (5.8%), and Enterobacter cloacae complex (2.9%). The overall rate of ESBL-producing Enterobacterales was 6.7%, and ranged from 1.0% in P. mirabilis to 19.5% in K. pneumoniae, and from 3.1% in outpatients to 13.6% in long-term care facilities. Overall, 4.1%, 9.3% and 10.5% of the isolates were resistant to cefoxitin, temocillin and pivmecillinam. Cotrimoxazole was the less active compound with 23.4% resistance. Conversely, 4.4%, 12.9%, and 14.3% of the strains were resistant to fosfomycin, nitrofurantoin, and ciprofloxacin. However, less than 1% of E. coli was resistant to fosfomycin and nitrofurantoin. We identified several trends in antibiotics resistances among Enterobacterales isolates recovered from the urinary tract samples in France. Carbapenem-sparing drugs, such as temocillin, mecillinam, fosfomycin, cefoxitin, and nitrofurantoin, remained highly active, including towards ESBL-E.

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Section: Discussionsupporting

confidence: 79%

Antimicrobial Resistance in Enterobacterales Recovered from Urinary Tract Infections in France

et al. 2022

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“…In this study, E. coli was the most commonly detected isolate (67.1%) followed by K. pneumoniae, and P. mirabilis, representing the three mostly reported uropathogens as shown in other publications [36,37]. Our study results are consistent with results from a previous study done in Lebanon revealing that E. coli has the highest incidence (60.53-73.98%) followed by K. pneumoniae (5.32-8.33%) [37] and another study demonstrating most frequent UTI isolates as E. coli (70%), K. pneumoniae (14%), and Pseudomonas (5%) [38].…”

Section: Discussionsupporting

confidence: 76%

Antimicrobial Susceptibilities and Laboratory Profiles of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Isolates as Agents of Urinary Tract Infection in Lebanon: Paving the Way for Better Diagnostics

et al. 2020

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Background: Urinary tract infections (UTIs) are major healthcare problems that are usually treated empirically. However, antimicrobial resistance has been increasing across many settings. This study aims to elucidate the antibiotic resistance profiles of three common uropathogens, Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Proteus mirabilis (P. mirabilis) and compare between extended spectrum beta-lactamase (ESBL) and non-ESBL strains among Lebanese patients. Methods: This retrospective study was conducted at multiple tertiary healthcare centers in South Lebanon, between January and September 2017, including 551 patients of all age groups. Demographic, clinical, and laboratory data of patients were collected and analyzed statistically. Results: The prevalence of UTI in Lebanon was highest in adults between 19 and 64 years (44%). E. coli was the predominant uropathogenic organism (67.1%) followed by K. pneumoniae (10%) and P. mirabilis (3.7%). ESBL represented 32.9% of the UTI agents. The three common uropathogens studied were found to be most susceptible to imipenem (100%) and meropenem (100%). Interestingly, 115 (25.1%) out of the 458 E. coli isolates were resistant to more than eight antibiotics while 107 (23.4%) were susceptible to all antibiotics studied. Conclusions: Our study underlined the importance of adequate antimicrobial prescription for UTIs in Lebanon to avoid multidrug resistance.

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“…On the other hand, the weakly represented species were Serratia liquefaciens , Citrobacter freundii and Enterobacter intermidius (0.97%). As expected, E. coli was the major Enterobacterales species among the urinary tract samples, which is similar to previous works in other countries [ 34 , 35 ]. However, the rate of 30.97% in this study is lower than the 72% recorded in France [ 36 ].…”

Section: Discussionsupporting

confidence: 91%

Susceptibility and Virulence of Enterobacteriaceae Isolated from Urinary Tract Infections in Benin

et al. 2023

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Enterobacteriaceae represent one of the main families of Gram-negative bacilli responsible for serious urinary tract infections (UTIs). The present study aimed to define the resistance profile and the virulence of Enterobacteriaceae strains isolated in urinary tract infections in Benin. A total of 390 urine samples were collected from patients with UTIs, and Enterobacteriaceae strains were isolated according to standard microbiology methods. The API 20E gallery was used for biochemical identification. All the isolated strains were subjected to antimicrobial susceptibility testing using the disc diffusion method. Extended-spectrum beta-lactamase (ESBL) production was investigated using a double-disc synergy test (DDST), and biofilm production was quantified using the microplate method. Multiplex PCR was used to detect uro-virulence genes, namely: PapG, IronB, Sfa, iucD, Hly, FocG, Sat, FyuA and Cnf, using commercially designed primers. More than 26% (103/390) of our samples were contaminated by Enterobacteriaceae strains at different levels. Thus, E. coli (31.07%, 32/103), Serratia marcescens (11.65%, 12/103), Klebsiella ornithinolytica (8.74%, 9/103), Serratia fonticola (7.77%, 8/103) and Enterobacter cloacae (6.80%, 7/103) were identified. Among the isolated strains, 39.81% (41/103) were biofilm-forming, while 5.83% (6/103) were ESBL-producing. Isolates were most resistant to erythromycin, cefixime, ceftriaxone and ampicillin (≥90%) followed by ciprofloxacin, gentamycin, doxycycline and levofloxacin (≥50%), and least resistant to imipenem (27.18%). In regard to virulence genes, Sfa was the most detected (28.15%), followed by IronB (22.23%), iucD (21.36%), Cnf (15.53%), PapG (9.71%), FocG (8.74%), Sat (6.79%), FyuA (5.82%) and Hyl (2.91%). These data may help improve the diagnosis of uropathogenic strains of Enterobacteriaceae, but also in designing effective strategies and measures for the prevention and management of severe, recurrent, or complicated urinary tract infections in Benin.

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Spectrum and patterns of antimicrobial resistance of uropathogens isolated from a sample of hospitalised Lebanese patients with urinary tract infections

Cited by 9 publications

References 21 publications

Antimicrobial Resistance in Enterobacterales Recovered from Urinary Tract Infections in France

Antimicrobial Resistance in Enterobacterales Recovered from Urinary Tract Infections in France

Antimicrobial Susceptibilities and Laboratory Profiles of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Isolates as Agents of Urinary Tract Infection in Lebanon: Paving the Way for Better Diagnostics

Susceptibility and Virulence of Enterobacteriaceae Isolated from Urinary Tract Infections in Benin

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