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Philippa C Matthews, Lucinda K Barrett, Stephanie Warren, Nicole Stoesser, Mel Snelling, Matthew Scarborough, Nicola Jones
BACKGROUND: Fosfomycin is increasingly called upon for the treatment of multi drug-resistant (MDR) organisms causing urinary tract infection (UTI). We reviewed oral fosfomycin use for UTI treatment in a large UK hospital. The primary goal was to audit our clinical practice against current national guidelines. Secondary aims were to identify factors associated with treatment failure, and to investigate the potential for using fosfomycin in patients with co-morbidities. METHODS: We retrospectively studied 75 adult patients with UTI who received 151 episodes of treatment with fosfomycin from March 2013 to June 2015...
October 11, 2016: BMC Infectious Diseases
Reza Ranjbar, Hamed Memariani, Rahim Sorouri, Mojtaba Memariani
Klebsiella pneumoniae is one of the most important agents of community-acquired urinary tract infection (CA-UTI). In addition to extended-spectrum β-lactamases (ESBLs), a number of virulence factors have been shown to play an important role in the pathogenesis of K. pneumoniae, including capsule, siderophores, and adhesins. Little is known about the genetic diversity and virulence content of the CTX-M-15-producing K. pneumoniae isolated from CA-UTI in Iran. A total of 152 K. pneumoniae isolates were collected from CA-UTI patients in Tehran from September 2015 through April 2016...
October 7, 2016: Microbial Pathogenesis
Mazen S Bader, Mark Loeb, Annie A Brooks
Urinary tract infections (UTIs) caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options. Gram-negative bacteria, specifically Enterobacteriaceae, are common causes of both community-acquired and hospital acquired UTIs. These organisms can acquire genes that encode for multiple antibiotic resistance mechanisms, including extended-spectrum-lactamases (ESBLs), AmpC- β -lactamase, and carbapenemases. The assessment of suspected UTI includes identification of characteristic symptoms or signs, urinalysis, dipstick or microscopic tests, and urine culture if indicated...
October 7, 2016: Postgraduate Medicine
L Gayani Tillekeratne, Dhammika Vidanagama, Rashmi Tippalagama, Rashmi Lewkebandara, Maria Joyce, Bradly P Nicholson, Ajith Nagahawatte, Champica K Bodinayake, Aruna Dharshan De Silva, Christopher W Woods
BACKGROUND: Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) are increasingly reported as pathogens in urinary tract infections (UTIs). However, in Sri Lanka, the clinical and molecular epidemiology of ESBL-PE implicated in UTIs has not been well described. MATERIALS AND METHODS: We conducted prospective, laboratory-based surveillance from October to December 2013 at a tertiary care hospital in southern Sri Lanka and enrolled patients ≥1 year of age with clinically relevant UTIs due to ESBL-PE...
September 2016: Infection & Chemotherapy
Mahbobeh Mohammad Tabar, Shiva Mirkalantari, Rabeeh Izadi Amoli
INTRODUCTION: The incidence of urinary tract infections caused by Extended-Spectrum Beta Lactamase (ESBL) producing Escherichia coli (E. coli) strains due to long term and overuse of broad-spectrum cephalosporine is on the rise. CTX beta-lactamase type, a broad-spectrum beta-lactamase, has been expanding in many countries. The ctx gene is harbored on a plasmid that is spread between Enterobacteriaceae family, especially in E. coli. The aim of this study was to determine the pattern of antimicrobial resistance and investigate the prevalent ESBL phenotype and the ctx-M gene in E...
July 2016: Electronic Physician
Lisa Jacmel, Sandra Timsit, Agnès Ferroni, Clémentine Auregan, François Angoulvant, Gérard Chéron
AIM: The last decade has seen a significant increase in extended-spectrum β-lactamase (ESBL) secreting organisms responsible for paediatric urinary tract infections (UTIs), particularly in community-acquired infections. These expose patients to the risks of antibiotic treatment failure and renal scarring. This prospective study examined the prevalence and risk factors of febrile ESBL UTIs and their treatment in the paediatric emergency department of a university hospital. METHODS: In this prospective observational study, all children from 0-16 years of age with febrile UTIs were included from May 2012-April 2013...
August 20, 2016: Acta Paediatrica
Dhivyalakshmi Shanmugam, Shamsadh Begum Esak, Anbumani Narayanaswamy
INTRODUCTION: Majority of Urinary Tract Infections (UTI's) are lower UTI's which constitute the real burden in the primary care setting and are usually treated empirically. Nitrofurantoin is an underused antimicrobial for empiric therapy for community-acquired and nosocomial lower UTIs. Nitrofurantoin has a wide spectrum of action against Escherichia coli, Klebsiella pneumonia and Enterococci, which are the frequent causes of nosocomial lower UTIs and also against multidrug-resistant gram-negative organisms including extended spectrum beta lactamase (ESBL) producers, Amp-C producers and Carbapenamase producers...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Nihal Uyar Aksu, Zelal Ekinci, Devrim Dündar, Canan Baydemir
BACKGROUND: This study aims to explore risk factors of childhood urinary tract infections (UTIs) associated with extended-spectrum β-lactamase (ESBL) producing bacteria (ESBL positive UTI) and to evaluate antimicrobial resistance as well as empiric treatment of childhood UTIs. METHODS: The records of children who had positive urine culture results between 1 January 2008 and 31 December 2012 were evaluated. Patients having positive urine culture results for ESBL-producing bacteria were defined as ESBL positive group whereas patients of same gender and similar age having positive urine culture results for non-ESBL-producing bacteria were defined as ESBL negative group...
August 8, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Myrto Eleni Flokas, Marios Detsis, Michail Alevizakos, Eleftherios Mylonakis
OBJECTIVES: We aimed to evaluate the prevalence of paediatric urinary tract infections (UTIs) caused by extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), identify predisposing factors and examine their effect on the length of hospital stay (LOS). METHODS: For this systematic review and meta-analysis, we searched the PubMed and EMBASE databases for studies that provide data on the rate of ESBL-PE among paediatric UTIs. RESULTS: Out of 1,828 non-duplicate citations, 16 studies reporting a total of 7,374 cases of UTI were included...
July 27, 2016: Journal of Infection
Sulaiman Ali Al Yousef, Sabry Younis, Eman Farrag, Husseiny Sh Moussa, Faten Sayed Bayoumi, Ahmed Mohamed Ali
BACKGROUND: Urinary tract infection (UTI) is mainly due to invasion of the urethra, bladder or kidneys by pathogens. The emergence of extended spectrum β-lactamases (ESBL) is responsible for frequently observed empirical therapy failures. OBJECTIVES: To study the clinical and laboratory characteristics of UTIs caused by ESBL producing Escherichia coli (E. coli) and Klebsiella pneumonia (K. pneumonia). METHODS: A cross-sectional clinical and laboratory study was performed at King Khalid Hospital, Hafr Al Batin, Saudi Arabia between March 2014 to October 2015...
July 2016: Annals of Clinical and Laboratory Science
Mohammad-Sadegh Damavandi, Abolfazl Gholipour, Mohammad Latif Pour
INTRODUCTION: Extended-spectrum β-lactamases (ESBLs) are a set of plasmid-borne, various and quickly evolving enzymes that are a main therapeutic issue now-a-days for inpatient and outpatient treatment. AIM: The aim of this study was to determine multi-drug resistance (MDR) and ESBLs producing E. coli strains, prevalence of class D Carbapenemases among ESBLs producing Escherichia coli isolates from educational hospitals in Shahrekord, Iran. MATERIALS AND METHODS: Uropathogenic Escherichia coli strains were isolated from patients with Urinary Tract Infections (UTIs)...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Fusun Can, Özlem Kurt-Azap, Pelin İspir, Elif Nurtop, Ceren Seref, İlayda Loçlar, Ozge Nur Aktaş, Yelda Ceren Orhan, Onder Ergonul
In this study, risk factors for ST131 H30 and H30-Rx subclones among urinary tract infections (UTIs) caused by multidrug-resistant (MDR) Escherichia coli were described. Urine samples were collected from consecutive outpatients registered to the outpatient clinics of Başkent University Hospital (Ankara, Turkey) with complaints of acute cystitis in 2011. A total of 107 MDR E. coli isolates were included in the study. Of the 107 isolates studied, 26 (24.3%) were typed as ST131 clone. Extended-spectrum β-lactamase (ESBL)-producers accounted for 59 (55...
March 2016: Journal of Global Antimicrobial Resistance
Yu Ting Chen, Katzrin Ahmad Murad, Lily Sy Ng, Jonathan Th Seah, Joon Jae Park, Thean Yen Tan
INTRODUCTION: Increasing resistance in Escherichia coli and Klebsiella pneumoniae to firstline antibiotics makes therapeutic options for urinary tract infections (UTIs) challenging. This study investigated the in vitro efficacies of 6 antibiotics against multidrug resistant (MDR) uropathogens. MATERIALS AND METHODS: Minimum inhibitory concentrations to ceftibuten, cefpodoxime, fosfomycin, mecillinam, temocillin, and trimethoprim were determined against 155 MDR-isolates of E...
June 2016: Annals of the Academy of Medicine, Singapore
Sareaa Al-Mayahie, Jaafar Jh Al Kuriashy
INTRODUCTION: Extended-spectrum β-lactamase (ESBL)-producing strains of Enterobacteriaceae are considered to be emerging pathogens. They are a major problem in hospitalized as well as community-based patients. Major outbreaks involving ESBL strains have been reported from all over the world. Recurrent urinary tract infection (UTI) is one of the risk factors for infection with ESBL-producing E. coli in hospitalized and non-hospitalized patients. METHODOLOGY: Ninety-one E...
2016: Journal of Infection in Developing Countries
M S Kumar, A P Das
Urinary tract infections (UTIs) are of great concern in both developing and developed countries all over the world. Even though the infections are more common in women and children, they are at a considerable rate in men and of all ages. The uropathogens causing the infections are spread through various routes. The treatment generally recommended by the physicians is antibiotic usage. But, most of the uropathogens have evolved antibiotic resistance mechanisms. This makes the present situation hectic in control and prevention of UTIs...
September 2016: Microbial Pathogenesis
Yoshifusa Abe, Hitomi Wakabayashi, Yasuha Ogawa, Ayano Machida, Mio Endo, Tetsuro Tamai, Shunsuke Sakurai, Satoshi Hibino, Takeshi Mikawa, Yoshitaka Watanabe, Kazuhisa Ugajin, Kunihiko Fukuchi, Kazuo Itabashi
To validate the policy of administering cefazolin (CEZ) as a first-line antibiotic to children who are hospitalized with their first febrile urinary tract infection (UTI), we evaluated microbial susceptibility to CEZ and the efficacy of CEZ. The 75 enrolled children with febrile UTI were initially treated with CEZ. Switching CEZ was not required in 84% of the patients. The median fever duration, prevalence of bacteremia, prevalence of UTI caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, and median duration of hospitalization were significantly higher in the CEZ-ineffective group...
2016: Global Pediatric Health
Khaireddine Bouassida, Mehdi Jaidane, Olfa Bouallegue, Ghassen Tlili, Habiba Naija, Ali Tahar Mosbah
INTRODUCTION: Our goal was to investigate the prevalence and antibiogram pattern of extended spectrum beta-lactamase (ESBL) production among uropathogens using isolates from urine samples collected at the Department of Urology in the Sahloul Hospital, Tunisia We also aimed to identify the risk factors for nosocomial urinary tract infections (UTIs) in patients who underwent transurethral resection of the prostate (TURP) and the measures for infection control. METHODS: Laboratory records of a five-year period from January 2004 to December 2008 were submitted for retrospective analysis to determine the incidence of ESBL infections...
March 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Florian M Wagenlehner, Jakhongir F Alidjanov
INTRODUCTION: Urinary tract infections (UTIs) are the second most common nosocomially acquired infections, responsible for approximately 21% of healthcare-associated pyelonephritis and 10.5% of urosepsis. Worldwide trends of increasing resistance resulted in the urgent need for novel antimicrobials that would be active against bacterial resistance mechanisms as an alternative to carbapenems, which are considered last resort antibiotics. AREAS COVERED: The current review is based on a Medline search of published English language literature and contains summary information regarding the evaluation of pharmacologic properties, efficacy, safety and activity of ceftolozane+tazobactam against common bacterial resistance mechanisms...
August 2016: Expert Opinion on Drug Metabolism & Toxicology
Fatemeh Yeganeh-Sefidan, Reza Ghotaslou, Mohammad Taghi Akhi, Mohammad Reza Sadeghi, Yalda Mohammadzadeh-Asl, Hussein Bannazadeh Baghi
BACKGROUND AND OBJECTIVES: The emergence and spread of multidrug resistant (MDR) and extended spectrum β-lactamase (ESBL) producing strains reduces the number of effective drugs that can be used for treatment. The aim of this study was to evaluate the susceptibility profile of Enterobacteriaceae isolated from UTIs, specifically MDR and ESBL producing strains, to fosfomycin and other antibiotics. MATERIALS AND METHODS: The study was performed during a 6 month period (February 2014 to August 2015)...
April 2016: Iranian Journal of Microbiology
Sibylle H Lob, Lindsay E Nicolle, Daryl J Hoban, Krystyna M Kazmierczak, Robert E Badal, Daniel F Sahm
Increasing antimicrobial resistance in urinary tract infections (UTI) is a concern. To evaluate resistance trends, 3498 Escherichia coli UTI isolates were collected from 2010 to 2014 in the Study for Monitoring Antimicrobial Resistance Trends (SMART) in Canada and United States (US). ESBL phenotype and susceptibility were determined using CLSI microdilution and breakpoints. US ESBL rates increased in 2010-2014 (7.8-18.3%, P < 0.0001), especially among hospital-associated (HA) infections, males, and older patients (≥65 years)...
August 2016: Diagnostic Microbiology and Infectious Disease
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