Epidemiological Study of Rapidly Emerging Uropathogens Isolated from Urinary Catheter and Its Influential Demographic Factors Responsible for Contamination

Urinary tract infections (UTI) are very common in all the developed as well as developing countries in which the majority of infections are catheter associated. Catheter associated urinary tract infections (CAUTI) is one of the major causes of hospital acquired infections. The aim of this study is to investigate influential demographic factors responsible for contamination associated with the rate of CAUTI, while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis, age, gender, and comparison with other studies. During the study, 22 uropathogenic species were isolated from the different segments of urinary catheter samples of the patients collected from 12 different hospitals of Amravati city, Maharashtra, India from January 2015 to 2018. Gram negative organisms were the most frequent isolates, with Pseudomonas aeruginosa (16.08%) being the most common followed by Escherichia coli (10%) and Candida albicans accounted for almost 11% of all the uropathogens. It was found that the majority of uropathogens were isolated from the section A (Catheter segment inside the bladder) and section E (Catheter segment connected to drainage tube) of the urinary catheter. The duration of the catheterization plays the major role in the contamination and further infection to continue. It was observed that the female catheterized patients are more prone to the contamination and infection as compared to male catheterized patient. The antibiotic sensitivity pattern indicates that MAR (Multiple Antibiotic Resistance) index was more than 0.2 for almost all the uropathogens tested concluding that there is antibiotic stress on uropathogens and rate of resistance increased rapidly. Also it was found that there was a statistically significant association between the duration of catheterization, type of disease, age of patient and type of catheter with respect to gender.

Epidemiologic Profile Urinary Tract Infections: Experience of the Microbiology Laboratory of the University Hospital Mohamed VI in Tangier

Urinary tract infection is one of the most common bacterial infections in humans. The urine cytobacteriological examination is the key test for its diagnosis. This work aims to Evaluate the prevalence of urinary tract infection at the Microbiology Laboratory of the University Hospital Mohamed VI in Tangier and to highlight its epidemiological and bacteriological characteristics. It was a descriptive study with retrospective data collection which took place from January 2021 to June 2022, at the Microbiology Laboratory of the university hospital Mohamed VI in Tangier. It covered all urine cytobacteriological examinations (ECBU) during the study period. We identified 77 cases of urinary tract infections out of 300 requests for (ECBU), that is a positivity rate of 25 %. The mean age was 55 years. The male gender was predominant. The epidemiological profile of the isolated strains was dominated by Enterobacteriaceae 81 %, followed by Gram-positive cocci 11 % and non-fermenting gram-negative bacteria 8 %. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli 42 %, Klebsiella pneumoniae 20 %, Enterobacter cloacae 9 %, Staphylococcus aureus 6 %, Pseudomonas aeruginosa 5 % and Acinetobacter baumannii 3%. Most of the analyzed organisms showed resistance, especially to the beta-lactam antibiotic;the enterobacteria strains isolated had revealed resistance to amoxicillin: 74%, to amoxicillin-clavulanic acid in 40% of cases, and to third-generation cephalosporins in 24%. In terms of resistance mechanisms, 11 % of the Enterobacteriaceae were extended-spectrum β-lactamase producers and 9 % of the specimens were identified as carbapenemase producers. Of the Staphylococcus aureus strains isolated, 75% were resistant to meticillin. The Glycopeptides and linezolid were the most active molecules on these isolated strains. 15% of Enterococcus species isolated in our laboratory were resistant to glycopeptides (vancomycin and teicoplanin).

Phytochemicals of Aloe barbadensis miller as Potential Inhibitors of Uropathogenic Escherichia coli for Urinary Tract Infection Therapy: An in Silico Approach

Urinary tract infections (UTIs) are common infections caused by normal skin or rectum bacteria that get into the urethra and infect the urinary tract. Although the infection can affect various parts of the tract, bladder infections are the most prevalent kind. Uropathogenic Escherichia Coli (UPEC) is the most common pathogen associated with UTI development. Therefore, inhibiting the UPEC protein target (PDB ID: 8BVD) appears to be a promising therapeutic strategy. Therefore, in this study, molecular docking and dynamics were conducted to examine the antibacterial activity of Aloe barbadensis miller against UPEC bacteria. The Aloe barbadensis miller natural compounds licochalcone A, palmidin B and palmidin C were downloaded from PubChem with amoxicillin, which was used as a control drug and studied against the target molecule. The potential parameters examined were the docking scores, absorption, distribution, metabolism, excretion, toxicity (ADMET), bioavailability, root mean square deviation (RMSD), root mean square fluctuation (RMSF), hydrogen bonding, radius of gyration, and potential energy of the system. Docking scores showed that all ligands demonstrated an admirable candidature as an inhibitor to 8BVD molecule, and the score hierarchy is licochalcone A (-6.4 kcal/mol), palmidin C (-6.1 kcal/mol), palmidin B (-6.0 kcal/mol), and amoxicillin (-5.9 kcal/mol). All ligands appeared to have good drug-like properties and oral bioavailability. Molecular dynamic studies showed that all ligands exhibited an excellent nominee as inhibitors in their vicinity at 20 ns. However, there is a relatively high fluctuation of palmidin B compared with other compounds, which seems to be more stable. This work suggests that the selected phytoconstituents could be used as inhibitors of the 8BVD protein in the fight against UTIs. However, further investigation on the clinical and experimental validation of UTI treatment’s specific mechanisms and effects is still welcomed.

Prevalence of Uropathogenic Escherichia coli among Adult Male Patients 40 Years and above with Haematuria and Impaired Kidney Attending General Hospitals in Benue State

Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of infection or other complications of the kidney. The aim of the study was to determine the prevalence of uropathogenic Escherichia coli among adult male patients with haematuria and impaired kidneys attending a general hospital in Benue state. Three hundred and sixty-eight (368) samples of urine were collected from 368 male patients (≥ 40 years) attending the 23 general hospitals in Benue state. Each of the urine samples was divided into two parts for haematuria and isolation and identification of Escherichia coli. Blood samples (368) were also collected from the patients and used for quantitative determination of creatinine and estimation of glomerular filtration rate. The presence of haematuria was 45.1% and ranges from 12.5% to 100%. Prevalence of haematuria with respect to age shows that patients within the age group of 90 - 99 years had the highest rate (100%) and the least were those within the ages of 40 - 49 years (20.0%). Isolation rate of uropathogenic Escherichia coli was 16.3% and ranged from 6.3 to 37.5%. Patients within the age group of 90 - 99 years had the highest elevated impaired renal function of 4 (80%), followed by patients within the ages of 80 - 89 years [17 (77.3%)] and the lowest were those within the ages of 40 - 49 [6 (10.0%)]. The overall presence of haematuria in the patients was high (45.1%) with similar high Escherichia coli isolation rate and impaired renal function which could mean that acute or chronic kidney disease may set in.

Prevalence and Associated Risk Factors of Uropathogenic Klebsiella Species in Port Harcourt

Background: Urinary tract infection (UTI) is a severe public health issue that affects a wide range of people around the world with Klebsiella pneumoniae accounting for up to 25% of all urinary tract infections. The higher rate of UTI associated with uropathogenic Klebsiella species has been associated with the emergence of hypervirulent and antibiotic-resistant strains facilitated by the misuse and overuse of antibiotics as well as other sociodemographic and behavioural practices of susceptible individuals. This study was aimed at investigating the prevalence and associated risk factors of uropathogenic Klebsiella species in Port Harcourt, Nigeria. Methodology: The study employed a descriptive cross-sectional study design comprising 300 subjects clinically suspected of having urinary tract infections attending the Rivers State University Medical Centre and the Rivers State University Teaching Hospital between March to August 2022. A standard urine culture procedure was used to ascertain significant bacteriuria after which Klebsiella colonies were isolated and identified using standard bacteriological techniques. The data generated from this study was represented as frequency and percentages, and inferential statistics were carried out using Chi-square with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval. Result: The prevalence of uropathogenic Klebsiella sp. was 16%, with sex, pregnancy status, and religion of the individuals substantially linked (p p Klebsiella species. Conclusion: This study reports a relatively high prevalence of uropathogenic Klebsiella species at 16%, with the sex and pregnancy status of the subjects being significantly associated (p Klebsiella species in the current study. Health promotion and awareness efforts should be prioritised to inform susceptible demographics about their risks for urinary tract infections associated with uropathogenic Klebsiella species via targeted educational campaigns, collaboration with healthcare providers, use of social media and online platforms, workplace wellness programs, and community outreach programs amongst others. Antimicrobial susceptibility testing before prescriptions and treatment should be emphasized and upheld in all clinical settings.

Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infection in Messalata Central Hospital, Libya

Objective: To investigate the prevalence of urinary tract infection among patients at Messalata Central Hospital, Libya, to identify the causative bacteria, and to explore their resistance pattern to antimicrobials. Methods: A total number of 1 153 urine samples were collected from patients, who attended daily to Messalata Central Hospital, Libya, in a study extended for one year. Antimicrobial susceptibility testing and isolates typing were done using Phoenix BD(BD diagnostic). Resistance was confirmed manually using agar disk diffusion method. Results: Of the 1 153 urine samples tested, 160(13.9%) samples were positive, from which 17 different, solely Gram negative, uropathogens were identified. Escherichia coli were the most prevalent(55.6%) bacteria, followed by Klebsiella pneumoniae subspecies pneumoniae(16.3%), Proteus mirabilis(6.3%), Pseudomonas aeruginosa(5.6%), Enterobacter cloacae and Klebsiella oxytoca(2.5%, each), Citrobacter koseri and Providencia rettgeri(1.9%, each), Acinetobacter baumannii, Enterobacter aerogenes and Proteus vulgaris(1.3%, each), and Aeromonas caviae, Citrobacter freundii, Cronobacter sakazakii, Enterobacter amnigenus biogroup 2, Pseudomonas putida and Serratia marcescens(0.6%, each). The isolated uropathogens showed increased levels of resistance ranged from 10.5% to 64.5%, with an overall resistance of 28.9%. Amikacin was the most effective antimicrobial followed by Imipenem and Meropenem(0%, 0.6% and 2.5% resistance, respectively); while, Cephalothin and Ampicillin were the least(80.6% and 90.0% resistance, respectively) effective. Conclusions: The obtained results emphasized the emergence of highly resistant bacteria to most of tested antimicrobials and raise the alarm for physicians to change their treatment pattern depending on antimicrobial susceptibility results.

Prevalence and antibiogram of bacterial isolates from urinary tract infections at Dessie Health Research Laboratory,Ethiopia

Objective:To determine the prevalence and antimicrobial susceptibility of bacteria from suspected urinary tract infections.Methods:A retrospective analysis of Imcterial pathogens and their antimicrobial susceptibility was done on urine samples at Dessic Regional Laboratory in the period 2003 to 2010.Antimicrobial susceptibility tests were done using disc diffusion technique as per the standard of Kirby-Bauer method.Results:The male to female ratio of the patients was 1:1.96.Of the total 1404 samples..119(22.7%,were culture positive.Escherirhia coli was the dominant isolate(63.6%) followed by Klebsiella spp.(8.5%) and Proteus spp.(8.2%).The overall resistance rates to erythromycin,amoxycillin,and tetracycline were 85.6%,88.9%and 76.7%,respectively,The three most frequently isolated bacteria had resistance rates of 80.1%-90.0%to.amoxycillin,and tetracycline and sensitivity rates of 0to 25%to nitrofurantoin,ciprofloxacin and genlamiein.Antibiogram of isolates showed that 152i47.85%isolates were resistance to two and more antimicrobials.Conclusions:In the study area resistance rates to erythromycin,amoxycillin and tetracycline were high.Since most isolates were sensitive to nitrofurantoin and gentamicin.they are considered as appropriate antimicrobials for empirical treatment urinary tract infections.

The Bacterial Isolates and Plasmid Profile of Extended Spectrum Beta-Lactamases Producers Causing Urinary Tract Infection among Pregnant Women in Uyo, Nigeria

Background: Extended spectrum beta-lactamases (ESBLs) are enzymes that compromise the efficacy of all beta-lactams and are spread by plasmids. They are of public health importance the world over;however, in Nigeria in general and Uyo in particular, tests for their detection are not routinely done in hospital laboratories despite increase in treatment failures observed for common clinical conditions like urinary tract infection. Objective: To isolate ESBLs producing uropathogens and the plasmid underlying their resistance to antibiotics. Materials and Methods: Three hundred urine specimens (n = 300) were collected from pregnant women attending antenatal clinics at St. Lukes Hospital, Anua, cultured and incubated according to accepted standard. Identification of isolates was done using Microbact 24E (Oxoid, UK) system. The predominant bacterial pathogens were Escherichia coli (42%) followed by Klebsiella pneumonia (21%), Klebsiella oxytoca (12%), Citrobacter spp. (5%), Proteus mirabilis (7%), Enterobacter spp. (12%) and Acinetobacter baumanii (1%). The isolated bacteria were tested for their antibiotic susceptibility using Clinical Laboratory Standard Institute (CLSI) recommended disc diffusion method. A Double Disk Synergy Test (DDST) and Phenotypic Disk Confirmatory Test (PDCT) were performed to determine ESBL production. Chromagar ESBL was also used to test for the presence of ESBL producing isolates. The plasmid content of ESBL producing isolates and their participation in drug resistance were investigated. Results: Of the 80 bacterial isolates causing urinary tract infection in these women, the ESBL producers were found to be 16 (20%). Out of these 16 ESBL producing urogenital isolates Klebsiella pneumonia (8, 50%) was the most prevalent. Others include Escherichia coli (38%), Klebsiella oxytoca (6%) and Enterobacter cloacae (6). Plasmid content of ESBL producing isolates was found to be 87.5%. Conclusion: The Extended Spectrum Beta-lactamase producing uropathogens mainly of plasmid origin are increasingly responsible for the cause of community acquired urinary tract infections in pregnant women in Uyo.

Clino-Pathological Features of Urinary Tract Infection in Rural India

The study was aimed to understand the clino-pathological characteristics of urinary tract infection along with the techniques used in diagnosis and treatment of the presenting infection. The study takes into consideration the various risk factors such as age, sex, and diabetes mellitus which can precipitate a urinary tract infection. The study was conducted at the Global Baroda Hospital, Vadodara and Narhari Hospital, Vadodara in the duration from January to March 2012, under the supervision of Dr. Hiten Kareliya. A questionnaire was prepared in accordance to evaluate risk factors of urinary tract infection. The patients under study were chosen according to specific inclusion criteria. The uropathogens were isolated with the help of biochemical testing. E. coli (38%) was found to be the most prevalent organism followed by Klebsiella and Candida albicans (both 10%), Pseudomonas aeruginosa (9%), Staphylococcus (7%).

Incidence and Etiology of Catheter Associated Urinary Tract Infection among Admitted Patients at Kabale Regional Referral Hospital, South Western Uganda

Introduction: Catheter Associated Urinary Tract Infection is the most common hospital acquired infection worldwide. Urinary Tract Infections among catheterised patients are on rise regardless of antibiotic use and this is due to erratic use of antibiotics, treatment failure, antimicrobial resistance and emergency of Extended Spectrum Beta Lactamase producing bacteria leading to patient distress, increased healthcare costs, long hospital stay and poor patient response to antibiotics. In Uganda, no previous studies have sought to study the burden of CAUTI among catheterized patients, the bacterial pathogens involved and their antimicrobial susceptibility patterns yet there is upsurge in antimicrobial resistance of uropathogens. The effective management of patients suffering from Catheter Associated Urinary Tract infection (CAUTI) relays on the identification of uropathogens that cause CAUTI and the selection of an effective antibiotic agent to the uropathen in question. Objectives: The objectives of this study were to determine incidence, etiology and antibiotic susceptibility pattern among the uropathogens causing Catheter Associated Urinary Tract Infections among patients with indwelling catheters at Kabale Regional Referral Hospital. Methods: Using a descriptive prospective observational hospital-based study, the study was conducted on 150 catheterized patients recruited from Emergency, Obstetrics and gynecology, Medical, Maternity and Surgical wards at Kabale Regional Referral Hospital between April and May 2019. The urine samples from study participants were processed in Kabale RRH microbiology laboratory as per standard operating procedures. After isolation and identification, all the isolates were subjected to antibiotic susceptibility testing for commonly used antibiotics. Results: Following the urine culture from 150 catheterized patients, urine from 23 (15.3%) patients showed significant growth. The common bacterial isolates were Escherichia coli 12 (52%), followed by the Klebsiella pneumoniae 6 (26%), Staphylococcus aureus 3 (13%) and Pseudomonas spp. 2 (8.7%). All Gram-negative isolates were sensitive to Imipenem 20 (100%) while all S. aureus isolates (3) were 100% sensitive to Vancomycin and Cefoxitin. Isolates were sensitive to Gentamicin 20 (82.6), Ceftriaxone 16 (69.6), Ciprofloxacin 10 (43.5) and Nitrofurantoin 9 (39.1). All isolates were 100% resistant to Cotrimoxazole. 6 gram negative isolates were resistant to ceftazidime and were tested for Extended Spectrum Beta (ß) Lactamase (ESBL), 5 (83.3%) were identified as ESBL-producing bacteria. K. pneumonia 3 (60%) presented the highest percentage of ESBLs as compared to E. coli 2 (40%). Conclusions: The Incidence of CAUTI among patients with indwelling urinary catheters at Kabale Regional Referral Hospital is high (15.3%) and is mostly caused by E. coli and K. pneumoniae. These bacteria are resistant to most commonly used antibiotics and thus there is a need to put more emphasis on CAUTI prevention strategies and use culture and sensitivity tests before prescription of antibiotics.

Incidence of Urinary Tract Infections and Its Aetiological Agents among Pregnant Women in Karnataka Region

Urinary tract infection (UTI) is the most common medical complications of pregnancy together with anaemia and hypertension and it occurs approximately in 5%-10% of all pregnancies. The aim of this study was to determine the incidence of UTI and prevalence of uropathogens among pregnant women. During the study period from December 2009 to August 2010, 417 urine samples were analyzed. UTI was diagnosed by growth of at least 105 CFU/ml of a urinary tract pathogen in a culture of a midstream urine sample. The isolated bacteria were identified by biochemical tests. The results showed that 49.4% of pregnant women have UTI. E. coli which was the most frequently isolated organism (56.79%), followed by Klebsiella sps (19.9%), Pseudomonas sps (6.3%), and Proteus sps (5.8%). Other pathogens isolated were Enterobacter (3.8%), Citrobacter (1.4%) and Enterococcus sps (0.9%). Of the variables examined, the highest prevalence rate was observed where, 53.3% of the infected women were in the age group 36 to 40 years, 54.15% were in their 3rd trimester;also the highest infection rate (70.2%) was observed in 7th month of pregnancy, concluding that old age pregnancy increased parity prone for UTI apart from individual hygiene and economical status.

Detection of Biofilm Forming Bacterial Communities from Urinary Catheter of Patients with Change in Its Antibiotic Susceptibility Pattern and Triclosan Effect from Different Hospitals of Amravati City Maharashtra, India

Purpose: Bacterial biofilm develop on the surfaces of urinary catheter and proceed to cause full blown bacterial infections and sepsis. Urinary catheters, infection rates increase with the duration of catheterization at rates of per day with virtually all of those who undergo long-term catheterization becoming infected. Also antibiotics results in the adaptation and development of resistance leading to treatment failure, prolonged hospitalization, increased costs of care, and increased mortality. Methods: In the present study total 200 used urinary catheters were studied from the different hospitals of Amravati city in 2015-2016. Different bacterial uropathogens were isolated by conventional method and biofilm formation was studied by tissue culture plate (TCP). Antibiotic sensitivity was performed by disc diffusion method. Minimum inhibitory concentration (MIC) and Minimum biofilm eradicating concentration (MBEC) of triclosan was determined by TCP. Results: Out of total samples 93% are contaminated. Around 59% urinary catheters contain mixed consortia. Pseudomonas aeruginosa was found to be the strong biofilm forming and multidrug resistant organism. The most effective drug over seven bacteria isolates were chloramphenicol. Triclosan was used to test against the strong and moderate biofilm forming isolates the MIC of triclosan ranged between 1.5 and 1000 μg/ml and MBEC was between 800 and 3200 μg/ml Conclusions: From the study it was concluded that female are more prone to be infected with catheter associated infection. Pseudomonas aeruginosa was found to be deadly caused of infection, as it is highly resistant to antibiotics. Also triclosan showed effective result on the bacterial uropathogens.

Regulation of fim genes in uropathogenic Escherichia coli

Uropathogenic Escherichia coli(UPEC)is the leading cause of urinary tract infections in women,causing significant morbidity and mortality in this population.Adherence to host epithelial cells is a pivotal step in the pathogenesis of UPEC.One of the most important virulence factors involved in mediating this attachment is the type 1 pilus(type 1 fimbria)encoded by a set of fim genes arranged in an operon.The expression of type 1 pili is controlled by a phenomenon known as phase variation,which reversibly switches between the expression of type 1 pili(Phase-ON)and loss of expression(Phase-OFF).Phase-ON cells have the promoter for the fimA structural gene on an invertible DNA element called fimS,which lines up to allow transcription,whereas transcription of the structural gene is silenced in Phase-OFF cells.The orientation of the fimS invertible element is controlled by two site-specific recombinases,FimB and FimE.Environmental conditions cause transcriptional and post-transcriptional changes in UPEC cells that affect the level of regulatory proteins,which in turn play vital roles in modulating this phase switching ability.The role of fim gene regulation in UPEC pathogenesis will be discussed.

Inhibitory Activities of Lactic Acid Bacteria against Multi-Drug Resistant Uropathogenic <i>Staphylococcus saprophyticus</i>Isolated from Symptomatic Women in Lagos, Nigeria

The uropathogenic Staphylococcus saprophyticus is reported severally to be resistant to the drugs often used empirically for treatment of urinary tract infections (UTIs). Their ability to exhibit resistance to multiple drugs is a great deal of threat to successes recorded in the management of UTIs caused by this pathogen. Lactic acid bacteria (LAB) have been demonstrated to exhibit antimicrobial activities but studies about their prospect against multi-drug resistant S. saprophyticus are quite few. This study therefore investigated activities of LAB against the multi-drug resistant S. saprophyticus recovered from urine samples of symptomatic women. The three different species of LAB (Lactobacillus fermentum BTA 62, Lactobacillus johnsonii BTA 86 and Weissella confusa BTA 40) previously isolated and identified by 16S rRNA sequencing were selected based on their history of antimicrobial activities. Their metabolites were employed in the antagonistic assays against six (6) multi-drug resistant test pathogens recovered from urine samples of symptomatic, non-pregnant women attending clinics in Lagos, Nigeria and the control (S. saprophyticus subs bovis strain DSM 18669) following standard procedures. The pathogens showed resistances to almost all the antibiotics except levofloxacin, ciprofloxacin, imipenem while the control showed resistance to three. The LAB, L. fermentum inhibited five (83.3%) of the pathogens with zone diameter of 12 - 17 mm, followed by W. confusa inhibiting three (50%) with 15 - 17 mm. Lactobacillus johnsonii on the other hand, inhibited a pathogen and the control with zones of 13 mm and 14 mm respectively. In conclusion, the extracted metabolites of LAB inhibited the growth of multi-drug resistant clinical isolates of uropathogenic S. saprophyticus and may therefore be potent alternatives to antibiotics.

Prevalence of multi-drug resistant uropathogenic Escherichia coli in Potohar region of Pakistan

Objective:To scrutinize patterns of multi-drug-resistant uropathogenic Escherichia coli(UPEC) strains and particularly of fluoroquinolone-resistance this is an alternative choice for the treatment of urinary tract infections.Methods:Bacterial samples(n = 250) were collected from out-patients from August 2012 to August 2014 Islamabad.Antibiotic susceptibility profiling and determination of minimum inhibitory concentrations(MICs) and minimum bactericidal concentrations were performed according to the guidelines of Clinical and Laboratory Standards Institute(CLSI,2012).Genes,qnrA,qnrB and qnrS were identified by DNA amplification and sequencing.Results:The highest percentage of UPEC isolates were resistant to co-trimoxazole(82%) followed by cephalothin(80%),2nd Gen,3rd Gen and 4th Gen cephalosporins,respectively.Resistance against gentamicin,amikacin remained 29% and 4%.For other drugs including nitrofurantoin,tetracycline,carbapenem and beta-lactam inhibitors remained below 10%.Altogether,59% of the isolates were resistant to at least three antibiotics including one fluoroquinolone.Overall,MICs for ciprofloxacin remained(MIC≥256 μg/mL) and for levofloxacin(MIC≥16 μg/mL and 32 μg/mL).No significant differences were observed regarding MIC values of extended spectrumβ-lactamase(ESBL) and non-ESBL producers.For qnrS and qnrB positive isolates MICs remained above 32 μg/mL.Prevalence of UPEC was significantly higher among females and 40% of the isolates were ESBL producers.Conclusions:Higher percentages of ESBL producing UPEC were associated with urinary tract infections.Moreover,the majority of these isolates were multi-drug resistant and fluoroquinolone-resistant.

Correlation of biofilm formation of uropathogenic Escherichia coli(UPEC) and fimbriae genotypes

Objective:In the present study we try to correlate between pathogenic intrinsic factor of Escherichia coli(E.coli) presented with different fimbria genotyes and biofilm formation with host immune factor entitled interleukin-6(IL-6) secretion as defense mechanism.Methods:A total of 91 pediatrics complaining of pyuria were included in the present study.In addition,20 healthy control children were included.Full microbiological study was performed for isolated E.coli.PapC alleles were studied by multiple alleles PCR and biofilm formation was studied.IL-6 was measured in urine.Results:IL-6 had statistically significant elevation in patients’urine compared to control.From biofilm study, it was found that 19 isolated E.coli had formed biofilm in vitro.Moreover,urine samples with positive biofilm formation of E.coli had statistically significant lower IL-6 secretion than those with negative E.coli for biofilms.The distribution of fimbria genotypes showed that the frequent genotype was for alleleⅠ(34.3%) followed by mixed allelesⅠandⅡ(24.1%).There was significant correlation between mixed alleles(Ⅰ&Ⅱ)and biofilm formation.Conclusion: The present study highlights the presence of significant strains of E.coli causing urinary tract infections capable of biofilm formation.Biofilm formation is associated with less innate immunity manifested by lower urinary IL- 6.The majority of isolates had fimbria genes.It appears that mixed allelesⅠandⅡhave prominent virulence effect with tendency for biofilm formation.

Bacterial Uropathogen among Benign Prostatic Hyperplasia Patients at a Tertiary Hospital in Nigeria

As the lumen of the prostatic urethra becomes compromised by fibroadenomatous growth in the periurethral region of the prostate of men with Benign prostatic hyperplasia (BPH), urine outflow is obstructed progressively resulting in incomplete bladder empting causing stasis and may predispose patients to infection. Mid stream urine samples were collected from 94 BPH patients. Macroscopy, microscopy, culture and antibiotic susceptibility test were carried out on isolated uropathogens. Isolated bacteria were characterized using biochemical tests. Isolated bacterial pathogens include Proteus mirabilis, Escherichia coli, Pseudomonas aeruginosa, Klebsiella oxytoca, Morgarella morgani, K. pneumonia and Enterococcus faecalis in order of frequency. The isolates show highest resistance of 87.1% to Ciprofloxacin and least resistance of 12.9% to Imipenem. The isolates were found to be multi-drug resistant and the 12.9% resistance to Imipenem suggests presence of Carbapenemase producing bacteria among the isolates.

Microbial Profile and Antibiotic Resistance Pattern of Urine and Biofilm Pathogens Isolated from Catheterized Patients at Komfo Anokye Teaching Hospital, Kumasi, Ghana

Introduction: Urinary tract infection represents more than 40% of all nosocomial infections of which 80% are attributed to the use of an indwelling urinary catheter. Although the device is useful medically to treat urinary retention and incontinence, its uses have also been associated with infections such as catheter-associated urinary tract infections. Objectives: To evaluate catheter-associated urinary tract infection in terms of its prevalence, pathogens causing the infection and the resistance pattern to some commonly used antibiotics. Methods: Urine and biofilm specimen were collected from 105 catheterized patients. Bacteria pathogens were identified based on colony morphology, Gram staining and other biochemical reactions. Kirby-Bauer disc diffusion method was employed to determine the antibiotic resistance pattern of the isolated pathogens. Results: The study recorded a 74.29% prevalence of catheter-associated urinary tract infection among the rarely symptomatic patients. Escherichia coli were significantly isolated (p < 0.000) in both samples compared to Klebsiella pneumoniae and Staphylococcus aureus. Most isolated pathogens from both samples were resistant to ciprofloxacin with the biofilm pathogens being highly resistant than the urine pathogens. K. pneumoniae from both samples showed higher resistance levels to antibiotics than E. coli and S. aureus. Conclusion: Ciprofloxacin, a commonly used antibiotic by catheterized patients turn out to be less effective against the pathogens. The use of ciprofloxacin in catheter-associated urinary tract infection treatment should therefore be given a second thought.

Genetic Diversity of Uropathogenic Escherichia coli Isolated from Human T Lymphotropic Virus Type I (HTLV-I) Infected Individuals

Urinary tract infection (UTI) is a frequent pathology among HTLV-I+ individuals being capable of severely compromising the kidneys and bladder. Molecular characteristics of uropathogenic Escherichia coli (UPEC) from HTLV-I+ infected individuals are unknown. UPEC isolates from HTVL-I+ individuals, with and without clinical symptoms of myelopathy, were submitted to genetic typing seeking to infer bacterial diversity and potential virulence. 71 bacterial isolates were characterized according to random amplified polymorphic DNA and phylotypes. Phylotyping classified E. coli into four phylogenetic groups: A (18.3%), B1 (16.9%), B2 (39.4%), and D (25.3%) and 8 phylotypes according to the presence of the genetic sequences chuA, yjaA and the DNA fragment TSPE4.C2: ﹣﹣﹣ (5.6%) and ﹣+﹣ (12.6%) in phylogroup A, ﹣﹣+ (7.0%) and ﹣++ (9.8%) in B1, +++ (32.3%) and ++﹣ (7.0%) in B2, +﹣﹣ (15.4%) and +﹣+ (9.8%) in D. The B2 phylogroup was the most prevalent among HTLV﹣ associated myelopathy and asymptomatic individuals. RAPD-PCR typing revealed a high degree of bacterial polymorphism indicating a non-clonal origin. Genotypes were not found to be distributed according to clinical status or epidemiological features. Our results lead us to suggest that the neurological impairment in HTLV-I+ individuals can be a risk factor for urinary infections due E. coli which are caused by distinct bacterial lineages.

Adherence of uropathogenic Escherichia coli to human primary epithelial cells of renal pelvis

Human primary epithelial cells of renal pelvis was established to investigate the adherence of uropathogenic Escherichia coli （UPEC） to this cell line, in which the primary cell culture was performed by using cultivation of the normal epithelium of renal pelvis in keratinocyte serum free medium （K-SFM） with epidermal growth factor （EGF） and bovine pituitary extract （BPE）. Both UPEC132 obtained from urine specimen of patients with pyelonephritis and the pilus-free representative strain E. coli K-12p678- 54 were used to study the adherence of these strains on human primary epithelial cells of renal pelvis. The UPEC adherence was performed with observation on the morphological changes of the adhered cells, while the adhesion rates and indices were calculated in different times of experiment. In addition, the virulence genes hly and cnfl of UPEC132 were detected by multiplex PCR assay. In this study, the human primary epithelial cells of renal pelvis was found to exhibit the character of the transitional epithelial cells. Compared with the control group, the adhesion rates and indices began to increase from 15 min of the experiment time and reached its peak in 120 min. The adhesion rate and index of UPEC132 to human primary epithelial cells of renal pelvis were 74.4% and 34.0 respectively. Many microscopic changes in the primary cells adhered with UPEC132 could be detected, such as rounding or irregularity in shape, unevenness in staining and the cytoplasmic and nuclear changes. It suggests that human primary epithelial cells of renal pelvis can be used for the experiment on UPEC adhesion, thus providing a basis for the further study on the pathogenesis of UPEC.