Prevalence and Antimicrobial Susceptibility Pattern of Pathogens Isolated from Different Age Groups with Urinary Tract Infection at Tangail, Bangladesh

Background: Urinary tract infections (UTIs) are commonly detected in several hospitals and typical medical health centres. The antibiotic policy must be updated based on current knowledge about causative agents and their antibiotic susceptibility patterns. The goal of this study was to find out exactly how frequently microbes cause urinary infections and their antibiotic susceptibility patterns. Methods: Mid-stream urine samples were analyzed microscopically for a routine examination, and bacterial pathogens were isolated by conventional culture method using Chromogenic UTI media and MacConkey agar culture media. A group of biochemical parameters were utilized for bacterial identification and characterization. Finally, in vitro antimicrobial susceptibility was performed by the Kirby- Bauer disc diffusion methods against 14 commercially available antibiotics. Results: A total of 1288 clinical samples from UTI patients were obtained aseptically, with 398 showing positive growth with a range of bacteria. Females have a higher prevalence of UTI than males. E. coli was the most common pathogen found (82.86%), followed by Enterococcus faecalis (8.44%), Klebsiella pneumoniae (5.63%), Pseudomonas aeruginosa (2.81%), and Proteus mirabilis (0.26%). The majority of the bacteria had a high sensitivity to Meropenem (98.25%); moderate sensitivity to Amoxicillin, Azithromycin, Ciprofloxacin, Gentamicin, Levofloxacin, Ceftriaxone, Cefepime, and Nitrofurantoin; and low sensitivity (20%) to Cefixime, Cephradine, Cefuroxime, Clindamycin, and Trimethoprime. Conclusion: These findings have clinical and epidemiological implications, improving study to identify causative pathogens and pathogen sensitivity patterns in urinary tract infections, as well as clinicians' knowledge of how to choose the best antibiotics and, ultimately, contributing to patient diagnosis and treatment.

Hibiscus sabdariffa extract inhibits in vitro biofilm formation capacity of Candida albicans isolated from recurrent urinary tract infections

<p><b>OBJECTIVE</b>To explore the prevention of recurrent candiduria using natural based approaches and to study the antimicrobial effect of Hibiscus sabdariffa (H. sabdariffa) extract and the biofilm forming capacity of Candida albicans strains in the present of the H. sabdariffa extract.</p><p><b>METHODS</b>In this particular study, six strains of fluconazole resistant Candida albicans isolated from recurrent candiduria were used. The susceptibility of fungal isolates, time-kill curves and biofilm forming capacity in the present of the H. sabdariffa extract were determined.</p><p><b>RESULTS</b>Various levels minimum inhibitory concentration of the extract were observed against all the isolates. Minimum inhibitory concentration values ranged from 0.5 to 2.0 mg/mL. Time-kill experiment demonstrated that the effect was fungistatic. The biofilm inhibition assay results showed that H. sabdariffa extract inhibited biofilm production of all the isolates.</p><p><b>CONCLUSIONS</b>The results of the study support the potential effect of H. sabdariffa extract for preventing recurrent candiduria and emphasize the significance of the plant extract approach as a potential antifungal agent.</p>

CTX-M-producing Escherichia coli and Klebsiella pneumoniae isolated from community-acquired urinary tract infections in Valledupar, Colombia

OBJECTIVE: Describe the presence of CTX-M-1 phylogenetic subgroup extended-spectrum i-lactamases (ESBL), associated with TEM and SHV genes, and the gene encoding cephalosporinase, CMY-2 in Escherichia coli and Klebsiella pneumoniae isolates from community-acquired urinary tract infections. METHODS: 102 E. coli and 21 K. pneumoniae were collected from patients with culture-proven urinary tract infection (UTI), during February and March, 2011. Antimicrobial susceptibility test was performed by disk diffusion according to the standards of the Clinical Laboratory Standard Institute. Screening for cephalosporins-resistant E. coli and K. pneumoniae was performed by PCR assay for blaTEM, blaSHV, blaCTX-M-1,-2,-8,-9, blaPER-2 and blaCMY-2 genes. Statistical analysis was performed by chi-squared test and multivariate logistic regression analysis. RESULTS: ESBL production was detected in 12 (11.7%) E. coli and four (19%) K. pneumoniae isolates. TEM ESBLs were detected in seven E. coli and three K. pneumoniae isolates. SHV ESBLs were found in four K. pneumoniae isolates. CTX-M-1 phylogenetic subgroup was positive in seven E. coli and three K. pneumoniae isolates. CMY-2 β-lactamase gene was detected in nine E. coli and one K. pneumoniae isolates. A significant association of ESBL expression in E. coli was observed with resistance to tobramycin (p < 0.001), tetracycline (p = 0.043), and ciprofloxacin (p < 0.001). In K. pneumoniae isolates, significant association was found with resistance to tobramycin and ciprofloxacin (p = 0.006), and trimethoprim-sulfamethoxazole (p = 0.043). Multivariate analyses did not show association between ESBL production in E. coli and K. pneumoniae, and resistance to non-β-lactams drugs. CONCLUSIONS: CTX-M ESBL in uropathogens isolated from the community is cause for concern due to the enormous potential for multidrug resistance from strains that produce these enzymes, which could lead to failure of empirically-administered therapies and development of complicated UTIs.

Necropsias de neonatos, fator da melhoria da qualidade nas UTIs neonatais / Neonatal necropsies as a factor in quality improvement of the neonatal ICUs

Neste estudo foram estudados 552 casos de necropsia de neomortos provenientes de unidades de terapia intensiva neonatais (UTINs). Desses, 265 apresentaram algum tipo de enfermidade ou lesão não esperada conseqüentes (direta ou indiretamente) a seu manuseio diagnóstico e/ou terapêutico. Os casos foram agrupados por tipo de enfermidade, em seus respectivos órgãos ou sistemas, que ressaltou a prevalência de lesões pulmonares, como membrana hialina, enfisema intersticial, displasia broncopulmonar e alterações graves em nível de sistema nervoso central (SNC), sinalizando o prognóstico quanto à qualidade de vida. Como parte das medidas terapêuticas, devem ser analisados os acessos arteriais e venosos dos vasos umbilicais, com suas complicações, e o acesso venoso profundo, propriamente dito, para nutrição parenteral total, com graves complicações fatais para o lado do coração, como endocardite fúngica e tamponamento cardíaco por "Intralipid". Foram discutidas as resultantes multissistêmicas dos quadros de hipotensão e choque: enterocolite necrotizante e necroses corticomedular, renal, hepática e miocárdica. Este trabalho ressalta o valor da necropsia na melhoria da qualidade das UTINs, bem como apresenta várias situações em que o diagnostico só foi conhecido devido à necropsia ou, então, o resultado modificou, de certa forma, a abordagem terapêutica futura. A consulta e a análise da literatura demonstram a virtual inexistência de metodologia adequada para desenvolver e estabelecer um comportamento que propicie o exercício sistemático de aferição do desempenho organizacional, e que reduza sensivelmente as possibilidades de efeitos indesejáveis relacionados com rotinas e procedimentos operacionais nesse campo da prática assistencial. As principais causas de insucesso parecem ser creditadas à tecnologia de máquinas e substâncias, cuja adequação à biologia dos organismos em desenvolvimento não é plenamente conhecida no que se refere à influência...

The present study emphasizes the necropsy value in the development of the neonatal ICU. We present many situations where the diagnostic was possible solely because of the necropsy, as well, many diagnosis were changed based on the necropsies results. The literature compilation shows no evidence of a systematic procedure concerning the mitigation of the problems related to the avaliable routines in this matter. The lack of a more scientific investigation related to the neonatal deaths is a enormous barrier to the improvement of those organizations (ITU's). Apparently, these failure is connected to machines and products thecnology not well know in terms of their suitability concerning under biological development organisms. Also, the necropsies appears to be a useful tool when the death results, directly or indirectly, from therapeutical process. The conception of a quality development process strategy represents a major issue, even more when you face new political decisions in health field, including cost reduction and higher complexity. Also, we need to pay special attention to science and research ethical principles.