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Angel Manjarrez-Hernandez, José Molina-López, Sandra Gavilanes-Parra, Rigoberto Hernandez-Castro
Escherichia coli clonal group A (CGA) causes urinary tract and other extraintestinal infections in humans. CGA is an important cause of trimethoprim/sulfamethoxazole (SXT)-resistance in extraintestinal pathogens. We examined the extent to which resistance in this area is related to CGA dissemination of E. coli from urinary tract infections (UTIs) in Mexico City. The virulence backgrounds of the isolates were also characterized. In this study, the frequency of resistance to SXT used for UTI treatment was high (56-65%) and CGA isolates accounted for 9 of the 78 SXT-resistant isolates (11...
November 7, 2016: Journal of Medical Microbiology
Ruth Wragg, Anna Harris, Mitul Patel, Andrew Robb, Harish Chandran, Liam McCarthy
AIM OF THE STUDY: Extended spectrum beta lactamase (ESBL) producing bacteria are resistant to most beta-lactam antibiotics including third-generation cephalosporins, quinolones and aminoglycosides. This resistance is plasmid-borne and can spread between species. Management of ESBL is challenging in children with recurrent urinary tract infections (UTIs) and complex urological abnormalities. We aim to quantify the risk in children and specifically in urological patients. METHODS: Retrospective review of a microbiology database (April 2014 to November 2015)...
November 13, 2016: Journal of Pediatric Surgery
Oona Nieminen, Matti Korppi, Merja Helminen
AIM: The impact of the emergence of antimicrobial resistant organisms has rarely been studied in children, including the healthcare costs of urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria. We evaluated the effect of ESBL on UTI healthcare costs and risk factors for paediatric UTIs. METHODS: This retrospective case-control study covered 2005-2014 and focused on children below 16 years of age treated in a University hospital: 22 children with UTIs caused by ESBL-producing bacteria and 56 ESBL-negative UTI controls...
November 7, 2016: Acta Paediatrica
Jonathan P Strysko, Vidya Mony, Jeremiah Cleveland, Hanna Siddiqui, Peter Homel, Christina Gagliardo
BACKGROUND: Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL) infections are increasing in both adults and children. The aim of this study was to describe the epidemiology of children with ESBL in an ethnically-diverse population, to determine what proportion of these infections were community-onset, and to identify risk factors predisposing children to ESBL acquisition. METHODS: A case-case-control study of children aged 0-18 years was conducted from 2012 to 2014...
November 24, 2016: Travel Medicine and Infectious Disease
Mark Melzer, Liana Macpherson, Catherine Welch
BACKGROUND: The clinical and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) services are well described. We used a blood culture database as a novel approach to case finding and determined its utility in identifying inpatients suitable for OPAT. METHODS: From December 2012 to November 2013, consecutive adult inpatients with bacteraemia, and those recruited to OPAT, were prospectively studied. Univariate and multivariate logistic regression analysis were used to investigate the association between bacteraemic patient characteristics and OPAT recruitment...
November 7, 2016: Postgraduate Medical Journal
Fardod O'Kelly, Siobhan Kavanagh, Rustom Manecksha, John Thornhill, Jérôme P Fennell
BACKGROUND: The prevalence of urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is increasing and the therapeutic options are limited, especially in primary care. Recent indications have suggested pivmecillinam to be a suitable option. This pilot study aimed to assess the viability of pivmecillinam as a therapeutic option in a Dublin cohort of mixed community and healthcare origin. METHODS: A prospective measurement of mean and fractional inhibitory concentrations of antibiotic use in 95 patients diagnosed with UTI caused by ESBL-producing Enterobacteriaceae was carried out...
November 3, 2016: BMC Infectious Diseases
Ingrid Cécile Djuikoue, Paul-Louis Woerther, Michel Toukam, Charles Burdet, Etienne Ruppé, Kamga Hortense Gonsu, Charles Fokunang, Assiya El Mniai, Kamgue Larissa, Anatole Constant Pieme, Mallila Georgia Mboupaing, Caroline Mietchop Kakam, Hervé Kengne Fogang, Antoine Andremont, Jeanne Ngogang
INTRODUCTION: During the last decade, the prevalence of the intestinal carriage of extended spectrum beta-lactamases - producing Escherichia coli (ESBL-E. coli) has continued to increase worldwide in the community, especially in developing countries. Hence, we undertook a study to determine the ESBL-E. coli fecal carriage rate and the associated risk factors in Cameroonian women. METHODOLOGY: A total of 86 women suspected of community-acquired urinary tract infections (UTI) were included in 10 health structures from May 2011 to April 2012...
October 31, 2016: Journal of Infection in Developing Countries
Anthony A Iwuafor, Folasade T Ogunsola, Rita O Oladele, Oyin O Oduyebo, Ibironke Desalu, Chukwudi C Egwuatu, Agwu U Nnachi, Comfort N Akujobi, Ita O Ita, Godwin I Ogban
BACKGROUND: Infections are common complications in critically ill patients with associated significant morbidity and mortality. AIM: This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital. MATERIALS AND METHODS: This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died...
2016: PloS One
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 to 16 years of age with febrile UTIs were included from May 2012 to 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 1828 non-duplicate citations, 16 studies reporting a total of 7374 cases of UTI were included...
December 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
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