Background: Urosepsis is life-threatening sepsis that leads to organ dysfunction and results from a defective response to a urinary tract infection;the major precipitating is obstructive uropathy in the upper or lower...Background: Urosepsis is life-threatening sepsis that leads to organ dysfunction and results from a defective response to a urinary tract infection;the major precipitating is obstructive uropathy in the upper or lower urinary tract (UT). The magnitude and burden of bacteria that caused uropathy were reported to increase annually. In 30% of all septic patients who were diagnosed with urosepsis, 1.5% of them were found in urology and a quarter due to hospital-acquired urinary tract infections (HAUTIs). This study aims to determine the clinical pattern and the frequency of commonly used antibiotics against bacteria associated with urosepsis among Sudanese patients. Methods: This was a cross sectional laboratory-based study, study subjects were recruited from patients attended to Gezira Hospital for Renal diseases and surgery (GHRDS) and was diagnosed, on clinical and laboratory basis, to have urosepsis. Hundred (n = 100) urine samples were collected and inoculated on cysteine lactose electrolyte deficient agar (CLED) media and identify using the suitable biochemical test and performed antimicrobial susceptibility testing (AST) by Kirby Bauer disc diffusion technique for selected antimicrobial agents, according to clinical laboratory standard institute (CLSI) guidelines. Results: Amongst urosepsis infection the frequency of E. coli, S. aureus, Proteus mirabilis, Klebseilla pneumonia and Pseudomonas aeruginosa were (37%, 21%, 10%, 6%, 4% respectively). Resistance to commonly prescribed antibiotics was high, ranging from 17% for meropenem to 100% for cefepime. P. aeruginosa was multidrug resistant compared with other isolates. Conclusions: There was high rate of antibiotic resistance against the common causes of urosepsis in GHRDS, and this reflects the importance of culture and sensitivity test and necessitates adoption of guidelines for selection of suitable antibiotic.展开更多
Background: Urosepsis is one of the most common infections that require empirical broad spectrum antibiotics immediately after diagnosis. This has led to development of bacterial resistance by acquiring the capability...Background: Urosepsis is one of the most common infections that require empirical broad spectrum antibiotics immediately after diagnosis. This has led to development of bacterial resistance by acquiring the capability to destroy the β-lactam ring. Methodology: This is a cross-sectional hospital-based study. The study was conducted from 2019 to 2020 at Gezira Hospital for Renal diseases and surgery (GHRDS). A hundred patients were diagnosed clinically with urosepsis and the isolated organisms were Escherichia coli, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumonia and Pseudomonas aeruginosa. The susceptibility test was conducted by Kirby Bauer disc diffusion technique according to clinical laboratory standard institute (CLSI) guidelines. Seventy eight samples of bacterial genomic DNA were confirmed by 16srRNA and multiplex PCR, were performed for genotypic blaOXA-51 and blaOXA-23 gene characterization of isolated bacteria. Then gel electrophoresis was used to identify the presence or absence of (blaOXA-51 and blaOXA-23) genes. Results: 88.5% (69/78) in 16srRNA detected. Using multiplex PCR, the frequencies of blaOXA-51 and blaOXA-23 genes were 13% and 10.1%, respectively. The percentages of isolates which yielded both blaOXA-51 and blaOXA-23 among P. aeruginosa was 25% (1/4), among K. pneumonia was 17% (1/6), and among E. coli was 8% (3/37). Only blaOXA-51 was detected in P. mirabilis 10% (1/10) and only blaOXA-23 was detected in S. aureus 5% (1/18). Conclusion: In this study, the presence of blaOXA-51 and blaOXA-23 genes was increased in the isolated bacteria.展开更多
文摘Background: Urosepsis is life-threatening sepsis that leads to organ dysfunction and results from a defective response to a urinary tract infection;the major precipitating is obstructive uropathy in the upper or lower urinary tract (UT). The magnitude and burden of bacteria that caused uropathy were reported to increase annually. In 30% of all septic patients who were diagnosed with urosepsis, 1.5% of them were found in urology and a quarter due to hospital-acquired urinary tract infections (HAUTIs). This study aims to determine the clinical pattern and the frequency of commonly used antibiotics against bacteria associated with urosepsis among Sudanese patients. Methods: This was a cross sectional laboratory-based study, study subjects were recruited from patients attended to Gezira Hospital for Renal diseases and surgery (GHRDS) and was diagnosed, on clinical and laboratory basis, to have urosepsis. Hundred (n = 100) urine samples were collected and inoculated on cysteine lactose electrolyte deficient agar (CLED) media and identify using the suitable biochemical test and performed antimicrobial susceptibility testing (AST) by Kirby Bauer disc diffusion technique for selected antimicrobial agents, according to clinical laboratory standard institute (CLSI) guidelines. Results: Amongst urosepsis infection the frequency of E. coli, S. aureus, Proteus mirabilis, Klebseilla pneumonia and Pseudomonas aeruginosa were (37%, 21%, 10%, 6%, 4% respectively). Resistance to commonly prescribed antibiotics was high, ranging from 17% for meropenem to 100% for cefepime. P. aeruginosa was multidrug resistant compared with other isolates. Conclusions: There was high rate of antibiotic resistance against the common causes of urosepsis in GHRDS, and this reflects the importance of culture and sensitivity test and necessitates adoption of guidelines for selection of suitable antibiotic.
文摘Background: Urosepsis is one of the most common infections that require empirical broad spectrum antibiotics immediately after diagnosis. This has led to development of bacterial resistance by acquiring the capability to destroy the β-lactam ring. Methodology: This is a cross-sectional hospital-based study. The study was conducted from 2019 to 2020 at Gezira Hospital for Renal diseases and surgery (GHRDS). A hundred patients were diagnosed clinically with urosepsis and the isolated organisms were Escherichia coli, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumonia and Pseudomonas aeruginosa. The susceptibility test was conducted by Kirby Bauer disc diffusion technique according to clinical laboratory standard institute (CLSI) guidelines. Seventy eight samples of bacterial genomic DNA were confirmed by 16srRNA and multiplex PCR, were performed for genotypic blaOXA-51 and blaOXA-23 gene characterization of isolated bacteria. Then gel electrophoresis was used to identify the presence or absence of (blaOXA-51 and blaOXA-23) genes. Results: 88.5% (69/78) in 16srRNA detected. Using multiplex PCR, the frequencies of blaOXA-51 and blaOXA-23 genes were 13% and 10.1%, respectively. The percentages of isolates which yielded both blaOXA-51 and blaOXA-23 among P. aeruginosa was 25% (1/4), among K. pneumonia was 17% (1/6), and among E. coli was 8% (3/37). Only blaOXA-51 was detected in P. mirabilis 10% (1/10) and only blaOXA-23 was detected in S. aureus 5% (1/18). Conclusion: In this study, the presence of blaOXA-51 and blaOXA-23 genes was increased in the isolated bacteria.