CATHETER-ASSOCIATED URINARY TRACT INFECTIONS CAUSED BY QUINOLONE-RESISTANT BACTERIA ISOLATED FROM ASSIUT UNIVERSITY HOSPITALS

Osama F. E. x E. Hassanein, Khaled M. Hassanein, Ahmed S. Ahmed, Wafaa E. Soliman, Gamal F. M. Gad

Abstract


The aim of the study was investigation of ciprofloxacin-resistant bacterial isolates in cases with catheter-associated urinary tract infections (CAUTIs). Study objectives included isolation and identification of the bacterial isolates and determination of their antibiogram.

For ciprofloxacin-resistant strains, the minimal inhibitory concentration was determined; host characteristics were also studied. The causative bacterial uropathogens detected in all the studied cases were headed by Klebsiella spp. (44.8%) followed by Pseudomonas aeruginosa (18.4%), Escherichia coli (17.6%) and Enterococcus species (14.4%). Quinolone resistance was found in 30 out of 100 patients studied (30%) and in  39 out of   125 bacterial isolates (31.2%). The highest rates of quinolone resistance were shown by Pseudomonas and Klebsiella spp. then E. coli. (39.1%, 32.1% and 31.8% respectively). It is noted that quinolone resistance was higher in patients with mixed bacterial infections (55.6%) than in patients with mono-bacterial infection (19.2%), that may suggest that mixed bacterial infection is a risk factors for development of quinolone resistance.



Keywords


Catheter, urinary, quinolone, resistance, Assuit.

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Al-Jiffri, O., El-Sayed, Z. M. F., & Al-Sharif F. M. (2011). Urinary Tract Infection with Esherichia coli and Antibacterial Activity of Some Plants Extracts. Intl. J. Microbiol. Res., 2 (1), 01-07.

Amábile-Cuevas, C. F., Arredondo-García, J. L., Cruz, A., &Rosas, I. (2010).Fluoroquinolone resistance in clinical and environmental isolates of Escherichia coli in Mexico City. J ApplMicrobiol., 108 (1), 158-62.

Barford, J. M. T., Coates, A. R. M., & George's S. (2009).The pathogenesis of catheter-associated urinary tract infection. Journal of Infection Prevention,VOL. 10, NO. 2., 50-56.

Bauer, A., Kirby, W., Sherris, J., &Turck, M. (1966). Antibiotic susceptibility testing by a standardized single disk method. Am. J. Clin. Pathol., 45 (4), 493-496.

Bonadio, M., Costarelli, S., Morelli, G., &Tartaglia, T. (2006). The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection. BMC Infect Dis., 6, 54.

Bouza, E., Juan, R. S., Munoz, P., Voss, A., &Kluytmans, J. (2001). A European perspective on nosocomial urinary tract infections I. Report on the microbiology workload, etiology and antimicrobial susceptibility (ESGNI_003 study). ClinMicrobiolInfec., 7, 523–531.

Clinical Laboratory Standards Institute (CLSI). (2016). Performance Standards for antimicrobial susceptibility testing: 26th informational supplement M100S. Wayne, Pennsylvania, USA: CLSI.

Colle, J. R., Miles, R. S. & Watt, B. (1996).Tests for identification of bacteria, in: Practical Medical Microbiology (14th edition).Colle J. G. Marmion B. P., Fraser A. G. and Simmons A. (ed.) Chirchill Livingstone, Newyork, N. Y. p. 131-149.

Crouzet, J., Bertrand, X., Venier, A. G., Badoz, M., Husson, C., & Talon, D. (2007). Control of the duration of urinary catheterization: Impact on catheter-associated urinary tract infection. Journal of Hospital Infection., 67, 253–257.

Croxall, G., Weston, V., Joseph, S., Manning, G., Cheetham, P. & McNally, A. (2011). Increased human pathogenic potential of Escherichia coli from polymicrobial urinary tract infections in comparison to isolates from monomicrobial culture samples. Journal of Medical Microbiology., 60, 102–109.

Dund, J. V. Dund, Ninama, R., Sinha, M. (2015). Antibiotic Sensitivity Pattern of Bacteria Isolated from Catheter Associated Urinary Tract Infections in Tertiary Care Hospital, Jamangar., Sch. J. App. Med. Sci.,3(5C):1985-1988.

Farmer, J. J., Fanning, G. R., Huntley-Carter, G. P., et al. (1981). Kluyvera, a new (redefined) genus in the family Enterobacteriaceae: identification of Kluyveraascorbata sp. nov. and Kluyveracryocrescens sp. nov. in clinical specimens. J. Clin. Microbiol.,13 (5), 919–33.

Gandhi, T., Flanders, S. A., Markovitz, E., Saint, S., &Kaul, D. R. (2009).Importance of urinary tract infection to antibiotic use among hospitalized patients. Infection Control and Hospital Epidemiology., 30.(2), 193-5.

García, J. L. A., & Cuevas, C. F. A. (2008). High resistance prevalence towards ampicillin, co-trimoxazole and ciprofloxacin, among uropathogenic Escherichia coli isolates in Mexico City.Infect Developing Countries., 2 (5), 350-353.

Gephart, P., Murray, R. G. E., Wood, W. A., & King, N. R. (1994).Methods for Genral and Molecular Bacteriology. ASM Press, Washington DC.

Gerald, L. M., Douglas, R. G., &Benette, J. E. (1990).Principlesand Practice of Infectious Diseases. 3rd edition., 582-590.

Hannan, T. J., Mysorekar, I. U., Hung, C. S., Isaacson-Schmid, M. L., Hultgren, S. J. (2010). Early Severe Inflammatory Responses to UropathogenicE. coli Predispose to Chronic and Recurrent Urinary Tract Infection. PLoSPathog., 6(8), e1001042.

Hooton, T. M. , Bradley, S. F. , Cardenas, D. D. , Colgan, R. , Geerlings, S. E. ,Rice, J. C. , Saint, S.,Schaeffer, A. J. ,Tambayh, P. A. , Tenke, P., & Nicolle L. E. (2010).Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America,Clinical Infectious Diseases,50 (5), 625–663.

Johansen, T. E. B., Cek, M., Naber, K., Stratchounski, L., Svendsen, M. V., &Tenke, P. (2007). Prevalence of Hospital-Acquired Urinary Tract Infections in Urology Departments. European Urology., 51, 1100–1112.

Kandel, S. H., El-Hendy, K. A. & Mohamed R. R. (2014). Prevalence of quinolones resistance among patients with urinary tract infection at Menoufia. Menoufia Med J., 27:440–446.

Khan, B. A., Saeed, S., Akram, A., Khan, F. B., &Nasim, A. (2010). Nosocomial Uropathogens And Their Antibiotic Sensitivity Patterns In A Tertiary Referral Teaching Hospital In Rawalpindi, Pakistan., J Ayub Med Coll Abbottabad., 22 (1), 11-12.

Khawcharoenporn, T., Vasoo, S. & Singh, K. (2013). Urinary Tract Infections due to Multidrug-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Chicago Emergency Department. Emergency Medicine International., Article ID 258517, 7 pages.

Khawcharoenporn, T., Vasoo, S., Ward, E., & Singh, K. (2012). High rates of quinolone resistance among urinary tract infections in the ED. American Journal of Emergency Medicine., VOL. 30, Issue 1, 68–74.

Khelkal, I. N. (2015). Biofilm formation and antibiotic resistance of uropathogenic E. coli isolated from urinary tract of catheterized patients.Journal of Genec and Environmental Resources Conservaon. 3(1):66-73.

Ko, M., Liu, C., Woung, L., Lee, W., Jeng, H., Lu, S., Chiang, H., & Li, C. (2008).Species and Antimicrobial Resistance of Uropathogens Isolated from Patients with Urinary Catheter. Tohoku J. Exp. Med.,214 (4), 311-319.

Kunin CM. (1979). Detection, prevention and management of urinary tract infections. 3rd ed. Lea and Febiger, Philadelphia, 1979.

Kunin, C. M., McCormack, R. C. (1966). Prevention of catheter-induced urinary tract infection by sterile closed drainage. N. Engl. J. Med. 274: 1155-1162.

Lau, S., Peng, M. & Chang, F. (2004). Resistance rates to commonly used antimicrobials among pathogens of both bacteremic and non-bacteremic community-acquired urinary tract infection. J MicrobiolImmunol Infect., 37:185-191.

Manning, S., Lautenbach, E., Tolomeo, P. & Han, J. H. (2015). Risk Factors for Infection with Escherichia coli in Nursing Home Residents Colonized with Fluoroquinolone-Resistant E. coli. Infect Control HospEpidemiol., 36(5): 575–577.

Milan, P. B., & Ivan, I. M. (2009). Catheter-associated and nosocomial urinary tract infections: antibiotic resistance and influence on commonly used antimicrobial therapy. IntUrolNephrol., 41, 461–464.

Namboodiri, S. S., Opintan, J, A., Lijek, R. S., Newman, M. J., &Okeke, I. N. (2011). Quinolone resistance in Escherichia coli from Accra, GhanaNamboodiri et al. BMC Microbiology., 11, 44, 1-9.

Nandini. M. S. &Madhusudan. K. (2016) reported from a study in India on 54 patients with CAUTI that the commonest bacterial uropathogens were E. coli (34.61%), Klebsiella species (21.15%) and Pseudomonas species (17.3%). Similarly Dund J. V. &Ninama R., et al (2015) reported that in CAUTI cases common uropathogens were E. coli (40.06%) and Klebsiella (21.8%).

Nicolle, L. E. (2014). Catheter associated urinary tract infections.Antimicrobial Resistance and Infection Control., 3:23.

Oni, A. A., Mbah, G. A., Ogunkunle, M. O., Shittu, O. B., &Bakare, R.A. (2003). Nosocomial infection: Urinary tract infection in patients with indwelling urinary catheter. Afr. J. Clin. Exper. Microbiol., VOL. 4, NO. 1, 63-71.

Patel, H. R. H., &Arya, M. (2000). The urinary catheter: ‘a voiding catastrophe’. Hosp Med., 62, 148—149.

Patil, T.(2014). Catheter Associated Urinary Tract Infection (Cauti) Induced Nosocomial Infection With Reference To Incidence, Duration And Organism In A Tertiary Care Teaching Hospital.International Journal of Medical Science and Education., Vol.1; Issue: 4; p 212-216.

Rao, S., Lin, X., Rao, D., & Yu, H. (2011). Flora distribution and drug resistance in catheter-associated urinary tract infection. International Journal of Urological Nursing., VOL. 5, NO. 1, 31-33.

Rao, S., Lin, X., Rao, D., & Yu, H. (2011). Flora distribution and drug resistance in catheter-associated urinary tract infection. International Journal of Urological Nursing., VOL. 5, NO. 1, 31-33.

Savas, L., Guvel, S., Onlen, Y., Savas, N., & Duran, N. (2006). Nosocomial Urinary Tract Infections: Micro-organisms, Antibiotic Sensitivities and Risk Factors. West Indian Med J., 55 (3), 188.

Soto, S. M. (2014). Importance of Biofilms in Urinary Tract Infections: New Therapeutic Approaches. Advances in Biology.,Volume 2014, Article ID 543974, 13 pages.

Taiwo, S. S., &Aderounmu, A. O. A. (2006). Catheter Associated Urinary Tract Infection: Aetiologic Agents and Antimicrobial Susceptibility Pattern in LadokeAkintola University Teaching Hospital, Osogbo, Nigeria.African Journal of Biomedical Research., VOL. 9, 141 – 148.

Tang, Y. W., Ellis, N. M., Hopkins, M. K., Smith, D. H., Dodge, D. E., &Persing, D. H. (1998). Comparison of phenotypic and genotypic techniques for identification of unusual aerobic pathogenic gram-negative bacilli.J. Clin. Microbiol.,36, 3674–3679.

Trautner, B. W. &Darouiche, R. O. (2004). Role of biofilm in catheter-associated urinary tract infection. Am J Infect Control., 32, 177-83.

Wazait, H. D., Patel, H. R. H., Veer, V., Kelsey, M., Meulen, J. H. P. V., Miller, R. A., &Emberton, M. (2003). Catheter-associated urinary tract infections: prevalence of uropathogens and pattern of antimicrobial resistance in a UK hospital (1996–2001). B. J. U. I N T E R N A T I O N A L., 9 1, 8 0 6 – 8 0 9.


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