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Naber KG, Alidjanov JF, Fünfstück R, Strohmaier WL, Kranz J, Cai T, Pilatz A, Wagenlehner FM. Therapeutic strategies for uncomplicated cystitis in women. GMS INFECTIOUS DISEASES 2024; 12:Doc01. [PMID: 38764941 PMCID: PMC11099625 DOI: 10.3205/id000086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Uncomplicated cystitis is affecting many women of all ages and has a great impact on the quality of life, especially in women suffering from recurrent, uncomplicated cystitis. By far the most frequent uropathogen, E. coli, may have acquired increasing resistance against a variety of oral antibiotics, which may differ between countries and regions. Therefore, local resistance data are important to be considered. On the other hand, non-antibiotic therapy has also become an option which should be discussed and offered to the patient. In patients suffering from recurrent uncomplicated cystitis, individual risk factors and possible behavioral changes should first be taken into account. Non-antimicrobial prophylactic strategies shown to be successful in well-designed clinical studies are the next options. Long term antibiotic prophylaxis, however, should only be considered as a last option. For some of those patients self-diagnosis and self-treatment may be suitable, e.g. by using a recognized questionnaire.
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Affiliation(s)
- Kurt G. Naber
- Department of Urology, Technical University of Munich, Germany
| | | | | | - Walter L. Strohmaier
- Medical School Regiomed, Coburg, Germany
- Julius Maximilian University, Wuerzburg, Germany
- University of Split, Croatia
| | - Jennifer Kranz
- Department of Urology and Pediatric Urology, University Medical Center RWTH Aachen, Germany
- Department of Urology and Kidney Transplantation, Martin Luther University, Halle (Saale), Germany
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Adrian Pilatz
- Clinic for Urology, Pediatric Urology and Andrology, Justus Liebig University of Giessen, Germany
| | - Florian M. Wagenlehner
- Clinic for Urology, Pediatric Urology and Andrology, Justus Liebig University of Giessen, Germany
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Assouma FF, Sina H, Adjobimey T, Noumavo ADP, Socohou A, Boya B, Dossou AD, Akpovo L, Konmy BBS, Mavoungou JF, Adjanohoun A, Baba-Moussa L. Susceptibility and Virulence of Enterobacteriaceae Isolated from Urinary Tract Infections in Benin. Microorganisms 2023; 11:microorganisms11010213. [PMID: 36677505 PMCID: PMC9864207 DOI: 10.3390/microorganisms11010213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Enterobacteriaceae represent one of the main families of Gram-negative bacilli responsible for serious urinary tract infections (UTIs). The present study aimed to define the resistance profile and the virulence of Enterobacteriaceae strains isolated in urinary tract infections in Benin. A total of 390 urine samples were collected from patients with UTIs, and Enterobacteriaceae strains were isolated according to standard microbiology methods. The API 20E gallery was used for biochemical identification. All the isolated strains were subjected to antimicrobial susceptibility testing using the disc diffusion method. Extended-spectrum beta-lactamase (ESBL) production was investigated using a double-disc synergy test (DDST), and biofilm production was quantified using the microplate method. Multiplex PCR was used to detect uro-virulence genes, namely: PapG, IronB, Sfa, iucD, Hly, FocG, Sat, FyuA and Cnf, using commercially designed primers. More than 26% (103/390) of our samples were contaminated by Enterobacteriaceae strains at different levels. Thus, E. coli (31.07%, 32/103), Serratia marcescens (11.65%, 12/103), Klebsiella ornithinolytica (8.74%, 9/103), Serratia fonticola (7.77%, 8/103) and Enterobacter cloacae (6.80%, 7/103) were identified. Among the isolated strains, 39.81% (41/103) were biofilm-forming, while 5.83% (6/103) were ESBL-producing. Isolates were most resistant to erythromycin, cefixime, ceftriaxone and ampicillin (≥90%) followed by ciprofloxacin, gentamycin, doxycycline and levofloxacin (≥50%), and least resistant to imipenem (27.18%). In regard to virulence genes, Sfa was the most detected (28.15%), followed by IronB (22.23%), iucD (21.36%), Cnf (15.53%), PapG (9.71%), FocG (8.74%), Sat (6.79%), FyuA (5.82%) and Hyl (2.91%). These data may help improve the diagnosis of uropathogenic strains of Enterobacteriaceae, but also in designing effective strategies and measures for the prevention and management of severe, recurrent, or complicated urinary tract infections in Benin.
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Affiliation(s)
- Funkè F. Assouma
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
| | - Haziz Sina
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
- Correspondence: (H.S.); (L.B.-M.)
| | - Tomabu Adjobimey
- Laboratory of Biochemistry and Molecular Biology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
| | - Agossou Damien Pacôme Noumavo
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
- Laboratory of Microbiology and Food Technologies, Department of Plant Biology, Faculty of Science and Technology, University of Abomey-Calavi, Cotonou 04 BP 1107, Benin
| | - Akim Socohou
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
| | - Bawa Boya
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
| | | | - Lauriane Akpovo
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
| | - Basile Boni Saka Konmy
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
- Department of Microbiology, International University of Libreville, ESSASSA-Libreville Campus, Essassa BP 20411, Gabon
| | - Jacques F. Mavoungou
- Department of Microbiology, International University of Libreville, ESSASSA-Libreville Campus, Essassa BP 20411, Gabon
| | - Adolphe Adjanohoun
- National Agronomic Research Institute of Benin, Cotonou 01 BP 884, Benin
| | - Lamine Baba-Moussa
- Laboratory of Biochemistry and Molecular Typing in Microbiology, Department of Biochemistry and Cell Biology, Faculty of Science and Technology, University of Abomey-Calavi, Abomey-Calavi 05 BP 1604, Benin
- Correspondence: (H.S.); (L.B.-M.)
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Naboka YL, Mavzyutov AR, Kogan MI, Gudima IA, Dzhalagoniya KT, Chernitskaia ML, Mitusova EV, Beloglazova NN. Biological properties of Gram-negative bacteria verified in urine of patients with recurrent uncomplicated lower urinary tract infection. MICROBIOLOGY INDEPENDENT RESEARCH JOURNAL 2022. [DOI: 10.18527/2500-2236-2022-9-1-82-90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Shen C, Zhu Q, Dong F, Wang W, Fan B, Li K, Chen J, Hu S, He Z, Li X. Identifying Two Novel Clusters in Calcium Oxalate Stones With Urinary Tract Infection Using 16S rDNA Sequencing. Front Cell Infect Microbiol 2021; 11:723781. [PMID: 34869053 PMCID: PMC8635737 DOI: 10.3389/fcimb.2021.723781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/25/2021] [Indexed: 02/01/2023] Open
Abstract
Urinary stones and urinary tract infection (UTI) are the most common diseases in urology and they are characterized by high incidence and high recurrence rate in China. Previous studies have shown that urinary stones are closely associated with gut or urine microbiota. Calcium oxalate stones are the most common type of urinary stones. However, the profile of urinary tract microorganisms of calcium oxalate stones with UTI is not clear. In this research, we firstly found two novel clusters in patients with calcium oxalate stones (OA) that were associated with the WBC/HP (white blood cells per high-power field) level in urine. Two clusters in the OA group (OA1 and OA2) were distinguished by the key microbiota Firmicutes and Enterobacteriaceae. We found that Enterobacteriaceae enriched in OA1 cluster was positively correlated with several infection-related pathways and negatively correlated with a few antibiotics-related pathways. Meantime, some probiotics with higher abundance in OA2 cluster such as Bifidobacterium were positively correlated with antibiotics-related pathways, and some common pathogens with higher abundance in OA2 cluster such as Enterococcus were positively correlated with infection-related pathways. Therefore, we speculated that as a sub-type of OA disease, OA1 was caused by Enterobacteriaceae and the lack of probiotics compared with OA2 cluster. Moreover, we also sequenced urine samples of healthy individuals (CK), patients with UTI (I), patients with uric acid stones (UA), and patients with infection stones (IS). We identified the differentially abundant taxa among all groups. We hope the findings will be helpful for clinical treatment and diagnosis of urinary stones.
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Affiliation(s)
- Chen Shen
- Departmant of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qianhui Zhu
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Fan Dong
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Wei Wang
- Departmant of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Bo Fan
- Departmant of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Kexin Li
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jun Chen
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Songnian Hu
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Zilong He
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing, China.,School of Engineering Medicine, Beihang University, Beijing, China
| | - Xiancheng Li
- Departmant of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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