Treatment of chronic relapsing urinary tract infection with antibiotics selected by AtbFinder

We report the case of a 46-year-old patient who, after renal cancer surgery, developed a recurrent urinary tract infection that lasted for more than 2 years. Despite repeated antibiotic courses, including broad-spectrum drugs chosen using conventional antibiotic susceptibility testing, multiple reinfections followed. The patient was successfully treated once antibiotics were selected with AtbFinder. Unlike routine antimicrobial susceptibility methods, which select antibiotics effective only against a "lead bacterial pathogen," AtbFinder identifies antibiotics that target the mixture of bacteria at the infection site. This case demonstrates the ability of AtbFinder to successfully select antibiotics for the treatment of relapsing urinary tract infections.

[The choice of antibiotic according the results of standard bacteriological analysis and express-method without isolation of pure cultures.]

The efficiency of choosing antibiotics using two methods was analyzed. The first method is based on standard laboratory analysis including isolation of pure cultures of prospective agent and detection of their individual sensitivity to antibiotics. The second method is based on a new express-technique permitting to simultaneously evaluate effect of pharmaceuticals on cultivated and not cultivated yet bacteria without isolation of pure cultures. At that, the second method permits to determine efficiency of antibiotics namely in those concentrations that can be made in the given nidus of infection. The study demonstrated existence of discrepancy between results obtained by using the given methods. The cause of discrepancy can be presence of not cultivated yet bacteria in pathologic sample. In favor of this assumption testify the received data concerning samples from patients where were presented a significant number of spore-former bacteria having additional mechanisms of resistance to antibiotics. Furthermore, the implemented study established antibiotics characterized by the greatest discrepancy of results obtained by applied methods that indicates the necessity of revision of schemes of implementation of start or empiric therapy.

[The choice of antibiotic in microbiological study of pyoinflammatory processes.]

The efficiency of application of test-system "Antibiotic Choice" was examined concerning evaluation of sensitivity to medications of maximal possible number of bacteria from pathological samples at burn trauma without isolation of pure culture. The results of metagenome analysis demonstrated that test-system permits supporting factually all bacteria discovered in wound discharge, including ones related to not cultivated yet. The comparison was carried out concerning results of standard identification of sensitivity of bacteria to antibiotics and efficient medication according the results of application of test-system "Antibiotic Choice". The obtained results demonstrate that test-system permits choosing antibiotic during 6-20 hours without separation of pure culture.