Bacterial Etiology and Antibiotic Susceptibility Patterns in Urinary Tract Infection among Patients with Various Renal Conditions

Authors

  • Mavra Saleem Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
  • Khawar Ali Shahzad Shanghai Fourth People’s Hospital, and School of Medicine, Tongji University, Shanghai, 200120, China
  • Muhammad Faizan Munawer Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
  • Munazzah Marryum Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan

DOI:

https://doi.org/10.53560/PPASB(62-2)1086

Keywords:

Antibiotic Susceptibility, Bacterial Etiology, Renal Conditions, Urinary Tract Infection

Abstract

Urinary tract infections (UTIs) are a common medical problem affecting a significant number of individuals around the world. The administration of UTIs in patients with renal abnormalities can be challenging, as these patients might require specific consideration and antibiotic regimens. The purpose of this study, which was carried out in the District Bahawalpur, was to investigate the prevalence, bacterial composition, and antimicrobial resistance pattern of UTIs in individuals with renal conditions, including renal calculi, renal cysts, and renal failure. In this descriptive cross-sectional study, 50 clinical samples from Bahawal Victoria Hospital, Bahawalpur, were subjected to microbiologic analysis using urine culture and drug susceptibility testing, and statistical analysis using descriptive statistics. Mean Patient Age was 28.52 ± 2.99, and the female to male ratio was 27:23. Among 50 patients 44% had right kidney stones, and 56% of patients faced UTIs for the first time. The most common pathogen was Escherichia coli (E. coli) (50%), which was followed by Klebsiella spp (20%), Pseudomonas spp (16%), Morganella spp (8%), and Staphylococcus aureus (6%). Azetronam was effective against some bacteria, including 4.0% of Escherichia coli and 8.0% of Klebsiella spp. Amoxicillin and Polymyxin were less effective than Augmentin and Amikacin, which were the most often used antibiotics. Our study demonstrates that antibiotic selection based on bacterial etiology is crucial for effective UTI treatment in patients with renal abnormalities. These findings improve patient outcomes and address the challenge of antibiotic resistance in patients with renal conditions.

References

1. C.H. Dawson and C.R. Tomson. Kidney stone disease: pathophysiology, investigation and medical treatment. Clinical Medicine (London) 12(5): 467-471 (2012).

2. P. Ract, F. Compain, F. Robin, D. Decre, S. Gallah, and I. Podglajen. Synergistic in vitro activity between aztreonam and amoxicillin-clavulanate against Enterobacteriaceae-producing class B and/or class D carbapenemases with or without extended-spectrum β-lactamases. Journal of Medical Microbiology 68(9): 1292-1298 (2019).

3. M. Säemann and W.H. Hörl. Urinary tract infection in renal transplant recipients. European Journal of Clinical Investigation 38(2): 58-65 (2008).

4. H. Park, S.W. Lee, G. Song, T.W. Kang, J.H. Jung, H.C. Chung, S.J. Kim, C.H. Park, J.Y. Park, T.Y. Shin, I.B. Suh, and J.H. Kim. Diagnostic Performance of %[-2]proPSA and Prostate Health Index for Prostate Cancer: Prospective, Multi-institutional Study. Journal of Korean Medical Science 33(11) : 94-100 (2018).

5. M.R. Asadi Karam, M. Habibi, and S. Bouzari. Urinary tract infection: Pathogenicity, antibiotic resistance, and development of effective vaccines against Uropathogenic Escherichia coli. Molecular Immunology 108(4): 56-67 (2019).

6. T. Sandle. Gram’s stain: history and explanation of the fundamental technique of determinative bacteriology. IST Science and Technology 54(1): 3-4 (2004).

7. R.A. Pollack, L. Findlay, W. Mondschein, and R.R. Modesto (Eds.). In: Laboratory exercises in Microbiology (5th Edition). John Wiley & Sons (2018).

8. A. Jeyakumari, L.N. Murthy, and S. Visnuvinayagam. Biochemical and microbiological quality changes of Indian oil Sardine (Sardinella longiceps) stored under flake ice and dry ice. International Journal of Current Microbiology and Applied Sciences 7(8): 2758-2765 (2018).

9. R. Hugh and E. Leifson. The taxonomic significance of fermentative versus oxidative metabolism of carbohydrates by various gram-negative bacteria. Journal of Bacteriology 66(1): 24-26 (1953).

10. M.A. Wikler. Performance standards for antimicrobial susceptibility testing. Clinical and Laboratory Standards Institute 32(1): 16-35 (2004).

11. R. Humphries, A.M. Bobenchik, J.A. Hindler, and A.N. Schuetz. Overview of Changes to the Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing, M100, 31st Edition. Journal of Clinical Microbiology 59(12): e0021321 (2021).

12. N.F.A. Heidar, J.A. Degheili, A.A. Yacoubian, and R.B. Khauli. Management of urinary tract infection in women: A practical approach for everyday practice. Urology Annals 11(4): 339-346 (2019).

13. K.U. Zubair, A.H. Shah, A. Fawwad, R. Sabir, and A. Butt. Frequency of urinary tract infection and antibiotic sensitivity of uropathogens in patients with diabetes. Pakistan Journal of Medical Sciences 35(6): 1664-1668 (2019).

14. I. Odongo, R. Ssemambo, and J.M. Kungu. Prevalence of Escherichia Coli and Its Antimicrobial Susceptibility Profiles among Patients with UTI at Mulago Hospital, Kampala, Uganda. Interdisciplinary Perspectives on Infectious Diseases 2020: 8042540 (2020).

15. I. Sorić Hosman, A. Cvitković Roić, and L. Lamot. A Systematic Review of the Unknown Host Immune Response Biomarkers for Predicting Recurrence of Urinary Tract Infection. Frontiers in Medicine (Lausanne) 9(1): 93-112 (2022).

16. J. Jayaweera and M. Reyes. Antimicrobial misuse in pediatric urinary tract infections: recurrences and renal scarring. Annals of Clinical Microbiology and Antimicrobials 17(1): 27 (2018).

17. A.K. Grosen, J.V. Povlsen, L.E. Lemming, S.M.D. Jørgensen, J.F. Dahlerup, and C.L. Hvas. Faecal Microbiota Transplantation Eradicated Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae from a Renal Transplant Recipient with Recurrent Urinary Tract Infections. Case Reports in Nephrology and Dialysis 9(2): 102-107 (2019).

18. R. Isac, D.G. Basaca, I.C. Olariu, R.F. Stroescu, A.M. Ardelean, R.M. Steflea, M. Gafencu, A. Chirita-Emandi, I.C. Bagiu, F.G. Horhat, D.D. Vulcanescu, D. Ionescu, and G. Doros. Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract. Children (Basel) 8(7): 585 (2021).

19. N.O. Eltai, A.A.Al Thani, K. Al-Ansari, A.S. Deshmukh, E. Wehedy, S.H. Al-Hadidi, and H.M. Yassine. Molecular characterization of extended spectrum β-lactamases enterobacteriaceae causing lower urinary tract infection among pediatric population. Antimicrobial Resistance and Infection Control 7: 90 (2018).

20. W. Dodd, K. Motwani, C. Small, K. Pierre, D. Patel, S. Malnik, B. Lucke-Wold, and K. Porche. Spinal cord injury and neurogenic lower urinary tract dysfunction: what do we know and where are we going? Journal of Men's Health 18(1): 024 (2022).

21. I. Hoeritzauer. Translational effects of neuro-urology research on clinical practice, Patient population–specific lower urinary tract symptoms. In: Neuro-Urology Research. A.M.J. Verstegen (Ed.). Elsevier pp. 121-140 (2023).

22. I. Eriksson, Y. Gustafson, L. Fagerström, and B. Olofsson. Prevalence and factors associated with urinary tract infections (UTIs) in very old women. Archives of Gerontology and Geriatrics 50(2): 132-135 (2010).

23. A. Velioglu, G. Guneri, H. Arikan, E. Asicioglu, E.T. Tigen, Y. Tanidir, İ. Tinay, C. Yegen, and S. Tuglular. Incidence and risk factors for urinary tract infections in the first year after renal transplantation. PLoS One 16(5): e0251036 (2021).

24. M.S. Bader, M. Loeb, D. Leto, and A.A. Brooks. Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents. Postgraduate Medicine 132(3): 234-250 (2020).

25. J.K.Y. Yap, S.Y.Y. Tan, S.Q. Tang, V.K. Thien, and E.W.L. Chan. Synergistic Antibacterial Activity Between 1,4-Naphthoquinone and β-Lactam Antibiotics Against Methicillin-Resistant Staphylococcus aureus. Microbial Drug Resistance 27(2): 234-240 (2021).

26. W.M. Kirby. Extraction of a highly potent penicillin inactivator from penicillin resistant staphylococci. Science 99(2579): 452-453 (1944).

27. B.J. Hartman and A. Tomasz. Low-affinity penicillin-binding protein associated with beta-lactam resistance in Staphylococcus aureus. Journal of Bacteriology 158(2): 513-516 (1984).

28. C.J. Hackbarth and H.F. Chambers. blaI and blaR1 regulate beta-lactamase and PBP 2a production in methicillin-resistant Staphylococcus aureus. Antimicrobial Agents and Chemotherapy 37(5): 1144-1149 (1993).

29. O. Herzberg and J. Moult. Bacterial resistance to beta-lactam antibiotics: crystal structure of beta-lactamase from Staphylococcus aureus PC1 at 2.5 A resolution. Science 236(4802): 694-701 (1987).

30. J.A.N. Alexander, L.J. Worrall, J. Hu, M. Vuckovic, N. Satishkumar, R. Poon, S. Sobhanifar, F.I. Rosell, J. Jenkins, D. Chiang, W.A. Mosimann, H.F. Chambers, M. Paetzel, S.S. Chatterjee, and N.C.J. Strynadka. Structural basis of broad-spectrum β-lactam resistance in Staphylococcus aureus. Nature 613(7943): 375-382 (2023).

31. P.S. Manshahia, M. Bisht, A. Mittal, M. Bhatia, and S.S. Handu. A prospective, follow up study to assess guidelines compliance in uncomplicated urinary tract infection. Journal of Family Medicine and Primary Care 9(8): 4292-4297 (2020).

32. S. Wawrysiuk, K. Naber, T. Rechberger, and P. Miotla. Prevention and treatment of uncomplicated lower urinary tract infections in the era of increasing antimicrobial resistance-non-antibiotic approaches: a systemic review. Archives of Gynecology and Obstetrics 300(4): 821-828 (2019).

33. A. Alqasim, A. Abu Jaffal, and A.A. Alyousef. Prevalence of Multidrug Resistance and Extended-Spectrum β-Lactamase Carriage of Clinical Uropathogenic Escherichia coli Isolates in Riyadh, Saudi Arabia. International Journal of Microbiology 2018: 3026851 (2018).

34. K.J. Wright and S.J. Hultgren. Sticky fibers and uropathogenesis: bacterial adhesins in the urinary tract. Future Microbiology 1(1): 75-87(2006).

35. T.J. Hannan, M. Totsika, K.J. Mansfield, K.H. Moore, M.A. Schembri, and S.J. Hultgren. Host-pathogen checkpoints and population bottlenecks in persistent and intracellular uropathogenic Escherichia coli bladder infection. FEMS Microbiology Review 36(3): 616-648 (2012).

36. T.J. Hannan, I.U. Mysorekar, C.S. Hung, M.L. Isaacson-Schmid, and S.J. Hultgren. Early severe inflammatory responses to uropathogenic E. coli predispose to chronic and recurrent urinary tract infection. PLoS Pathogen 6(8): e1001042 (2010).

37. G. Rajivgandhi, M. Maruthupandy, and N. Manoharan. Detection of TEM and CTX-M genes from ciprofloxacin resistant Proteus mirabilis and Escherichia coli isolated on urinary tract infections (UTIs). Microbial Pathogen 121(1): 123-130 (2018).

38. Z. Aktaş, N. Gönüllü, M. Şalcioğlu,Ç. Bal, and Ö. Anğ. Moxifloxacin activity against clinical isolates compared with the activity of ciprofloxacin. International Journal of Antimicrobial Agents 20(3): 196-200 (2002).

39. I.López Montesinos, S.Gómez-Zorrilla, Z.R. Palacios-Baena, N. Prim, D. Echeverria-Esnal, M.P. Gracia, M.M. Montero, X. Durán-Jordà, E. Sendra, L. Sorli, R. Guerri-Fernandez, E. Padilla, S. Grau, and J.P. Horcajada. Aminoglycoside or Polymyxin Monotherapy for Treating Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant Pseudomonas aeruginosa: A Propensity Score-Adjusted and Matched Cohort Study. Infectious Diseases and Therapy 11(1): 335-350 (2022).

Downloads

Published

2025-06-04

How to Cite

Saleem, M., Shahzad, K. A., Munawer, M. F., & Marryum, M. (2025). Bacterial Etiology and Antibiotic Susceptibility Patterns in Urinary Tract Infection among Patients with Various Renal Conditions. Proceedings of the Pakistan Academy of Sciences: B. Life and Environmental Sciences, 62(2), 127–136. https://doi.org/10.53560/PPASB(62-2)1086

Issue

Section

Research Articles

Similar Articles

<< < 5 6 7 8 9 10 11 12 > >> 

You may also start an advanced similarity search for this article.