Microbiological Spectrum and Antibiogram of Urinary Tract Infection in a Tertiary Care Center from the Kingdom of Bahrain.

Urinary tract infection is the second-most common after respiratory infections. This is a single-center retrospective study conducted in Bahrain Specialist Hospital, Bahrain. Urine culture data from November 2011 until December 2020 was obtained from the hospital database. Out of 28082, 4849 (17.3%) cultures were positive. One hundred and thirty-four (2.8%) showed the growth of multiple organisms. The male-to-female ratio was 3.7. Most of the patients [1872 (39.7%)] were 20-40 years. Men and women were 53.84 ± 25.85 and 43.41 ± 23.89 years, respectively; P <0.001. 4118/4715 (87.3%) were Gram-negative. Five hundred and sixty-four (11.9 %) and 33 (0.7%) were Gram-positive cocci and fungi, respectively. Escherichia coli (E. coli) was the most common and Klebsiella species were second-most common, accounting for 2916 (61.8%) and 586 (12.4%), respectively. 30.2% of all E. coli and 130 (22.2%) of all Klebsiella species were extended-spectrum beta-lactamase (ESBL) producers. ESBL Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus faecalis were present more in inpatients (P <0.001). P. aeruginosa was found more in women (P <0.001). E. coli was resistant to cotrimoxazole, ciprofloxacin, and levofloxacin in 28%, 17.3%, and 18.1%, respectively. ESBL E. coli and ESBL K. pneumoniae were resistant to amoxicillin-clavulanate, cotrimoxazole, ciprofloxacin, and levofloxacin in 73.8%, 62.3%, 62.4%, 58.4% and 68.2%, 62.6%, 55.7%, and 41.8% respectively. There is a high incidence of ESBL E. coli and ESBL K. pneumoniae. There is alarmingly increased resistance of P. aeruginosa to carbapenems. Amoxicillin-clavulanate, cefixime, and cefuroxime are suitable oral antibiotics for empirical treatment. For sick patients, piperacillin-tazobactam, aminoglycosides, and carbapenems should be considered. Antibiotic stewardship is the need of an hour.

Spectrum of Causative Pathogens and Resistance Rates to Antibacterial Agents in Bacterial Prostatitis.

OBJECTIVE: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. MATERIALS: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. RESULTS: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathogens); none for macrolides against atypical pathogens, but 20% and 27% for fluoroquinolones and tetracyclines. In West Africa, the resistance rates were generally higher, although the highest rates for ampicillin, cephalosporins, and fluoroquinolones were observed in the Gulf area. Lower rates were observed in Southeastern Europe. CONCLUSIONS: Resistance to antibiotics is a health problem requiring local health authorities to combat this phenomenon. Knowledge of the spectrum of pathogens and antibiotic resistance rates is crucial to assess local guidelines for the treatment of prostatitis.

Successful elimination of hemodialysis-related bacteremia and vascular access infection.

Hemodialysis (HD) related bacteremia and dialysis induced infection constitute major risk factors for mortality and morbidity among patients with end stage renal disease. In this retrospective study, we attempted to assess the impact of the infection control protocol introduced in our center on the prevalence of HD related bacteremia and vascular access infection. All the HD sessions performed over 8 years, from January 2004 till the end of December 2011, were included in this study. Over 108 months of the study period, 6161 HD sessions were performed on 118 patients. Demographic data of all the study patients were collected. The type of vascular access as well as the presence of diabetes and hypertension were recorded. During the study period, 15 episodes of dialysis related bacteremia were noted in nine patients. Three of them required hospitalization for administration of parenteral antibiotics. Blood cultures in 93% of the infection episodes (14/15) grew Sphingomonas paucilomobilis. One patient had methicillin resistant Staphylococcus aureus grown on blood culture. The prevalence of HD related bacteremia and vascular access infection in our unit were lower than international published data. The infection control protocol used seems to have been successful in reducing HD related bacteremia and eliminating vascular access infection.