The prevalence of multiple drug resistant urinary tract infections

Alhomayani, Faisal; Alazwari, Naif M.; Alshhrani, Mohammed S.; Alkhudaydi, Ali S.; Basaba, Abdullah S.; Alharthi, Tariq; Alghamdi, Muhanad M.; Aljuaid, Abdulaziz; Alosimi, Nasser M.; Alqethami, Abdulmajeed M.

doi:10.15537/smj.2022.43.8.20220238

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…A recent single-centered, observational, retrospective study from Saudi Arabia reported a lower rate of MDR amongst Proteus species (12.5%). This discrepancy could be ascribed to different study design, where only patients diagnosed with UTIs were included in that study [23].…”

Section: Discussionmentioning

confidence: 96%

Antimicrobial Susceptibility Trends of Proteeae Isolates From a Tertiary-Care Hospital in Western Saudi Arabia

El-Kady,

Alotaibi,

Aljabri

et al. 2023

Cureus

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Background: The tribe Proteeae comprises Proteus, Providencia, and Morganella species. These Gramnegative rods are of concern in that they are involved in diverse human infections, particularly in hospital settings. In the last two decades, there has been a sharp increase in infections by multidrug-resistant (MDR) Proteeae. Therefore, the objectives of this study were to: (i) assess the prevalence of infections caused by tribe Proteeae, (ii) determine the antimicrobial susceptibility profile of the test isolates, and (iii) identify the underlying risk factors for acquisition of infection by MDR strains.Methods: During the period from January 2019 to December 2020, we conducted a retrospective review of the electronic medical and laboratory records of adult patients who received care at our institution. In addition, we analyzed the risk factors associated with acquisition of infections by members of the tribe Proteeae using univariate and multivariate regression models.Results: Overall 403 adult patients (average age 59.69 ± 20.33 years) were enrolled into this study (196 males; 48.6%, and 207 females; 51.4%). Proteus mirabilis was the leading pathogen (70.7%; n=285), followed by Morganella morganii (20.1%; n=81), and Providencia species (9.2%; n=37). Most of the isolates were recovered from urine (59.3%; n=239), followed by wound swabs (23.1%; n=93), with the least from blood samples (1.7%; n=7). Out of 403 Proteeae isolates, 27.3% (n=110) were found to be extended-spectrum βlactamase (ESBL)-producers, whereas 18.4% (n=74) were MDR. Patient's age, concomitant diabetes mellitus (DM), and long hospital stays were independently associated with infection by MDR strains.Conclusion: Infections by MDR Proteeae are leading causes for morbidity in our tertiary-care facility. Strict adherence to infection control precautions, as well as effective implementation of antimicrobial stewardship programs, are crucial to overcome these superbugs.

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Section: Discussionmentioning

confidence: 96%

Antimicrobial Susceptibility Trends of Proteeae Isolates From a Tertiary-Care Hospital in Western Saudi Arabia

El-Kady,

Alotaibi,

Aljabri

et al. 2023

Cureus

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“…Globally, notable MDR bacteria include Gram-negative bacteria, such as members of Enterobacteriaceae producing plasmid-mediated, extended-spectrum β-lactamase (ESBL), and Gram-positive bacteria, such as MRSA and vancomycin-resistant Enterococci (VRE). The emergence of MDR UTIs is a significant public health concern, demanding appropriate measures to prevent their spread and manage affected patients [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Antimicrobial Resistance Patterns of Urinary Tract Infections: A Cross-Sectional Study from Southwestern Saudi Arabia

Alhazmi,

Alameer,

Abuageelah

et al. 2023

Medicina

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Background: Urinary tract infections (UTIs) are a prevalent form of urinary tract diseases affecting individuals of all ages and genders. In the Kingdom of Saudi Arabia (KSA), UTIs are a significant burden on the healthcare system, comprising 10% of all infections and ranking as the second leading cause of emergency department admissions. Despite this, limited research has been conducted in Saudi Arabia, particularly in Jazan Province, located in the southwestern region. Methods: This retrospective, cross-sectional study encompassed individuals with positive urine cultures who sought care at a tertiary hospital in Jazan between January 2022 and March 2023. A standardized data collection form was utilized to retrieve relevant information from microbiology lab test results and patients’ electronic medical records. Variables such as sex, urine sample collection date, bacterial isolates, antibiotic sensitivity, and resistance were collected using the data collection form. Data were analyzed using SPSS software, version 23.0 (IBM Corp., Armonk, NY, USA). Results: A total of 1082 urinary bacterial samples were isolated and identified. Females accounted for more bacterial infections (62.66%) than males (37.34%). Gram-negative bacteria represented 94% of all isolated strains. The most prevalent pathogens associated with UTIs were Escherichia coli (47.97%), Klebsiella pneumoniae (24.58%), and Pseudomonas aeruginosa (11.55%). Antimicrobial resistance patterns indicated the presence of extended-spectrum beta-lactamase (ESBL) (30.13%), carbapenemase-resistant Enterobacter (CRE) (1.94%), methicillin-resistant Staphylococcus aureus (MRSA) (0.74%), and vancomycin-resistant Enterococci (VRE) (0.18%). UTI incidence demonstrated a higher prevalence in September (13%) compared to other months in 2022. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the predominant Gram-negative multidrug-resistant organisms (MDRO), accounting for 34.42%, 13.95%, and 1.63% of the population. Conclusions: The prevalence of UTIs caused by antibiotic-resistant microbes is notable in Jazan. Consistent with findings from other regions, Escherichia coli remains the most common causative pathogen of UTIs, displaying a seasonal pattern that warrants attention. Approximately 35% of reported cases involve MDRO, with ESBLs accounting for 30%. These results should raise concerns among healthcare officials, highlighting the necessity for further investigations into factors contributing to the circulation of MDRO in Jazan.

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Uropathogens and their antibiotic susceptibility patterns among diabetic patients at st. john of god hospital, duayaw nkwanta, Ghana: a cross‐sectional study

Iddrisu,

Owusu,

Doe

et al. 2024

Health Science Reports

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BackgroundUropathogens are microorganisms that cause urinary tract infections (UTIs). Owing to higher blood glucose levels and compromised immune functions, treatment of uropathogens in diabetic patients is a challenge.AimThis study aims to assess the prevalence of uropathogens and their antibiotic susceptibility among diabetic patients at St. John of God Hospital at Duayaw Nkwanta (SJGHDN) in the Ahafo region of Ghana.MethodsThe cross‐sectional study recruited 175 diabetic patients at SJGHDN between August and September 2023. Questionnaires were used to collect patients’ background information. Fasting Blood Sugar (FBS) was assessed by using a glucometer. Urine samples were examined for the presence of uropathogens. A sterile inoculating loop with a calibrated volume of 2 µl was used for plating. Each colony equals 500 CFU/mL. Significant uropathogen was determined by multiplying the counted colonies by 500 to obtain CFU/mL. Positive uropathogen was defined as CFU ≥ 105/mL. Significant uropathogen was defined as ≥200 colonies per sample. The disc diffusion method was used to determine antibiotic susceptibility.ResultsOut of the 175 patients, 19.4% expressed various uropathogens with Escherichia coli being the predominant. Suboptimal glucose level was the most significant risk factor (p = 0.038). Glucosuria (p = 0.036), hazy urine (p = 0.028), positive leukocyte esterase (p = 0.001), and pus cells in urine sediment (p = 0.020) were significant indicators of uropathogen occurrence. Klebsiella pneumonia and Proteus mirabilis were resistant to ≥4 antibiotics. Amikacin, nitrofurantoin, levofloxacin, ciprofloxacin, and ceftriaxone demonstrated efficacy against the isolates.ConclusionThis study underscores the notable prevalence of uropathogens in diabetic patients and the alarming levels of antibiotic resistance observed. The results highlight the critical need for vigilant monitoring and customized treatment approaches, particularly for diabetic patients exhibiting risk factors such as elevated urine glucose levels, cloudy urine, and presence of leukocyte esterase and pus cells in urine sediment. The significant resistance to frequently used antibiotics like co‐trimoxazole and tetracycline points to the necessity of routine susceptibility testing and the use of alternative antibiotics for effective treatment. These findings can assist healthcare providers in more effectively managing and preventing UTIs in diabetic populations.

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The prevalence of multiple drug resistant urinary tract infections

Cited by 4 publications

References 17 publications

Antimicrobial Susceptibility Trends of Proteeae Isolates From a Tertiary-Care Hospital in Western Saudi Arabia

Antimicrobial Susceptibility Trends of Proteeae Isolates From a Tertiary-Care Hospital in Western Saudi Arabia

Epidemiology and Antimicrobial Resistance Patterns of Urinary Tract Infections: A Cross-Sectional Study from Southwestern Saudi Arabia

Uropathogens and their antibiotic susceptibility patterns among diabetic patients at st. john of god hospital, duayaw nkwanta, Ghana: a cross‐sectional study

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