Alterations in antibiotic susceptibility of urinary tract infection pathogens

Urinary tract infection [UTI] is the third most common infection in human. New resisted strains of uropathogens have been developed due to different factors such as widespread use of antibiothics. We conducted this study to assess the recent pattern and susceptibility of uropathogens. This descriptive cross-sectional study was carried on 32600 ambulatory patients' urine samples from six laboratories from 2008 to 2010 in Ahvaz, Khuzestan. Of those, 3000 positive culture were found. Data including underlying disease, pregnancy, catheterization and drug history were gathered by questionnaire. Susceptibility of pathogens to eight antimicrobial agents was determined. Mean age of patients was 33.87 +/- 3.80 years and 84.9% of them were female. The results showed that, E. coli, Kelebsiella and Enterobacter were the most common pathogens [73.5%, 13.8% and 6.6%, respectively]. E. coli was susceptible to Ciprofloxacin, Amikacin, and Nitrofurantoin in 76.9%, 76.4% and 76.1% of cases, respectively. Klebsiella was more susceptible to Ciprofloxacin, Ceftizoxim and Amikacin in 81.1%, 79.9% and 87.7% of positive cultures. Enterobacter was most susceptible to Ciprofloxacin [71.7%], but completely resistant to Ampicillin unexpectedly. E. coli and other isolates were more sensitive to Gentamicin, Amikacin and Ciprofloxacin compared to the other antibiotics tested and therefore these may be the drugs of choice for the empiric treatment of community-acquired UTI in our region

Changes in plasma concentrations of hypoxanthine and uric acid before and after hemodialysis

Purine metabolites constitute a major class of uremic toxins, and reliable characterization of which helps nephrologists to choose the most appropriate treatment for the patients individually. In the present study, we assessed plasma concentrations of hypoxanthine and uric acid as purine metabolites in patients on maintenance hemodialysis, before and after a dialysis session. A total of 20 patients on maintenance hemodialysis were enrolled in this study. All of the patients underwent a routine 4-hour dialysis, as scheduled 3 times per week. Polysulfone membranes and bicarbonate dialysis solution were used in all dialysis sessions. Blood specimens were taken from the arteriovenous fistula immediately before and after one hemodialysis session, in order to measure plasma concentrations of hypoxanthine and uric acid by high-performance liquid chromatography, and to compare the predialysis and postdialysis values. Before hemodialysis, the mean plasma hypoxanthine and uric acid concentrations were 18.93 +/- 8.28 micro mol/L and 44.16 +/- 22.88 micro mol/L, respectively. After hemodialysis, these concentrations reduced to 13.68 +/- 4.42 micro mol/L and 15.61 +/- 11.12 micro mol/L, respectively. Hypoxanthine concentration had a 27.7% decrease after hemodialysis [mean difference, 5.25 +/- 6.24 micro mol/L; 95% confidence interval, 2.32 to 8.10; P < .001]. Also, uric acid concentration decreased by 64.6% [mean difference, 28.55 +/- 14.39 micro mol/L; 95% confidence interval, 21.81 to 32.28; P < .001. Plasma concentrations of hypoxanthine and uric acid are higher than normal before hemodialysis, and they decrease significantly after hemodialysis; however, both of them may be still higher than normal values