European Journal of Molecular & Clinical Medicine

Urinary Tract Infection (UTI) is an infection of one or more structures in the urinary system. The urinary tract includes urethra, bladder, ureters, prostate and kidneys. Clinical presentation of UTI varies from asymptomatic infection to full blown pyelonephritis. Some symptoms may be non-specific and frequently symptoms overlap in patients with lower UTIs and upper UTIs. Present study was undertaken to isolate and characterize pathogens causing UTIs in patients attending, DMCH Darbhanga,  a rural tertiary care hospital and to study the antimicrobial sensitivity pattern of the urinary isolates, so as to provide a basic guideline in treating UTIs.
Methodology: A total of 500 midstream urine (MSU) samples were taken from both male and female patients who had clinically suspected UTI .They were asked to collect a fresh sample of MSU in a sterile container after cleaning the genitals with soap and water. The sample was transported to the microbiology laboratory and processed by wet film microscopy, Gram’s stain and semiquantitative culture in blood agar and MacConkey’s agar .All the isolates were identified by standard procedures and antimicrobial susceptibility test was done for the bacterial isolates.
Conclusion: The most common uropathogen isolated in our study was E. coli. Pseudomonas aeruginosawas the second major pathogen isolated from UTI. In the present study, overall incidence of UTI observed among males is marginally higher than that was observed in females. High rate of UTI was observed in children of 0 – 9 years of age.

Urinary tract infection (UTI) is one of the leading causes of morbidity encountered in clinical practice. Emerging resistance of the uropathogens to the antimicrobial agents due to biofilm formation is a matter of concern while treating symptomatic UTI which leads to longer stay in hospital and increased cost of treatment. Detection of biofilm producer strains will guide the clinician in modifying antibiotic therapy for better clinical management and also help in designing adequate control measures as the isolates are also resistant to variety of disinfectants.
Aim: The present study was conducted to compare three methods Tissue Culture Plate (TCP) method, Tube method (TM) and Congo red agar (CRA) to detect biofilm formation by uropathogens and to correlate their susceptibility pattern with biofilm formation.
Materials and methods: A total of 150 culture positive significant isolates from urine samples were subjected to biofilm detection by TCP method, Tube method and CRA method. TCP was considered as gold standard method. Impact of biofilm production was correlated with the antibiotic resistant pattern.
Results: Out of 150 culture positive significant bacterial isolates, Gram negative organisms were isolated from 122 (81.33%) specimens and Gram positive growth was seen in 28 (18.67%) samples. Escherichia coli was the commonest Gram negative organism isolated (42.66%) while among Gram positive isolates, maximum biofilm production was shown by Enterococcus faecalis (66.66%). The gold standard TCP method detected 51 (34%) isolates as strong and 11(7.33%) isolates as moderate biofilm producers and remaining 88 (58.67%) isolates were weak/non-biofilm producing bacteria.
Conclusion: From our study we can conclude that TCP is the most reliable method for detection of biofilm formation in comparison to TM and CRA.

Background: Urinary tract infection isamong the most common bacterial infections ingeneral population.The etiology as well as antibiotic sensitivity pattern of UTI varies with the widespread availability of antimicrobial agents; As a result of widespread use of antimicrobial agents, UTIs are becoming increasingly difficult to treat as pathogens with increasing resistance to commonly used antimicrobials are encountered more frequently in clinical practice.
Methods: A cross-sectional study done during April 2021-April2022. All positive urine culture and sensitivity reports of males and females aged 10-80years were included. A total of200 positive urine culture cases were taken from the culture and sensitivity register from Microbiology department of Hindu Rao Hospitaland details were tabulated using a questionnaire.
Results: Out of200 adults, males were 62 (31 %) and females were 138 (69 %). E. coli (63.1%) was the most common organism, followed byEnterococcus (17.68), Klebsiella Pneumoniae (11.1%) Pseudomonas and Staphylococcus. The incidence of UTI was morein female patients in the agegroup of21-30years.E.coli andKlebsiella weresensitive to Amikacin (97.1%), Nitrofurantoin (90.7%), Gentamycin and Imipenem. Both organisms were resistant to Ampicillin (>90%).
Conclusions: In this study, females were predominately affected and on culture the most common organisms were E. coliand Klebsiella. These organisms were most sensitive to Amikacin, Nitrofurantoin and resistant predominantly to Ampicillin. While planning treatment for UTI the sensitivity and resistance pattern ofuropathogensto common antimicrobial agents must betaken into account.

Introduction: Asymptomatic bladder infection that is detected by a positive urine culture is also common among diabetes mellitus patient which progress to symptomatic infection and subsequent complication. Therefore, it becomes essential to screen urinary tract infection in diabetes mellitus patient so that its progress to complication can be prevented. Hence present study has been designated to know the prevalence of asymptomatic bacteriuria among females affected with diabetes mellitus.

Urinary tract infections (UTI) are the most common bacterial infections during pregnancy.
Untreated UTI can be associated with serious obstetric complications. This cross-sectional
study was carried out to determine the prevalence of UTI among pregnant women. UTI was
diagnosed using mid stream urine (MSU) culture. Using >10’5 colony forming unit per millilitre
as a significant level of bacteriuria, the prevalence was found to be. There was a high
incidence of infection in 21-25 years age group (43.75%). There was also a high incidence of
infection in the third trimester of pregnancy (51.56%) compared to first (17.18%) and second
trimester (31.25%). Multiparty is associated with increased urinary tract infections in pregnancy.
Regarding education 10% were literate and 90 % were illiterate. Prevalence of bacteriuria
was 94% in women who had past history of urinary tract infection.80% were sexually
active. E.coli was the most frequently isolated pathogen. These findings underscores the importance
of screening all pregnant women for significant bacteriuria, so that positive cases
should be treated subsequently with antibiotics in order to reduce the adverse effects on both
maternal and fetal health.

Background: Urinary Tract Infections (UTI) are a common cause of fever and are one of the most common bacterial infections seen in children. It is the most common reason that make under 5 children visit Emergency/Outpatient departments. The reported rate of recurrent UTI is around 12- 30% with risk greater in Infants < 6 months, severe vesico-ureteric reflux and abnormal nuclear renal scans at time of first infection.
Material and Method: Cross-sectional study was carried out among 378 children in age group of two months to six years who were admitted in Pediatrics ward of tertiary care hospital with complaint of Fever. A pre-designed, structured questionnaire was used to collect information from participants which included demographic data, clinical presentation and clinical examination findings. The diagnosis of Urinary Tract Infection was confirmed by urine culture. The collected information was entered in Microsoft-Excel 2007 Software. Data was analyzed by using SPSS software version 17.0.
Results: The prevalence of Urinary Tract Infection in the present study came out to be 11.9%. The age group and sex of child was found to have statistically significant association with Urinary Tract Infection. Pain in abdomen/back/flank, burning micturition and increased urine frequency were also having statistically significant association with Urinary Tract Infection. On Urine microscopy examination, occasional pus cells were observed in 3.97% children, less than 5/hpf pus cells were observed in 8.73%, 5-10/hpf pus cells were observed in 6.35% children whereas plenty of pus cells were observed in 12.7% children.
Conclusions: The prevalence of UTI was less in children less than 2 years of age. Females had a higher prevalence of UTI as compared to males.

Background: One of the most common reasons to visit OPD in subjects of age less than 5
years is fever. Very little attention is given to UTIs (urinary tract infections) as the cause of
fever compared to other infections getting more attention. Without evaluating UTIs
adequately, antibiotics are commonly given to children empirically. To minimize lifelong
morbidity and provide prompt treatment, identification of UTI in children with fever is vital.
Aims:The present study was conducted to assess the UTI prevalence in subjects of age under
5 years and to assess the validity of urine culture and urine analysis for diagnosing urinary
tract infection.

Background and Objective: E.coli bacteria is the common cause of the urinary tract infections as it is responsible for about 90% of cases of urinary tract infections and it is considered one of the main problems in hospital infected. So, this study aimed to assess the genetic effects of ciprofloxacin, trimethoprim, alcoholic pomegranate Granada extract and alcoholic Trigonella foenum on coliform bacteria. Materials and methods: The bacteria were isolated from urinary tract infections, after they were diagnosed using an optical microscope and conducting biochemical tests, then exposed to the antibiotic Ciprofloxacin, trimethoprim, and alcoholic extract of pomegranate Granada and Trigonellafoenum. Genomic DNA was extracted for all samples and Random amplified polymorohic DNA - Polymerase chain reaction (RAPD- PCR) marker was carried out using five randomprimers. Results: The results of RAPD-PCR profiles shown thate xposed to antibiotics (ciprofloxacin and trimethoprim) and alcoholic extracts (pomegranate Granada and Trigonellafoenum) lead to the disappearance or appearance new bands compared with non-exposed samples, and the highest rate of polymorphisim for all each treats and primers in sample 3 was 105.88% where the ratio % GTS for all treats and primers is 10% in the same sample. Conclusion: All treatments caused genetic changes in the DNA of E.coli bacteria cells especially the pomegranate Granada which gave the highest effect than the rest of the treatments, this indicates its efficiency in treating bacterial infections

The present study included the collection of 121 samples from midstream urine for investigating the presence of K.pneumoniae in urinary tract infections, the samples were collected from Al-Shaheed Mohammed Baqir AL-Hakeem hospital and private laboratories in Baghdad province. The study was carried outthrough March 2019 to the beginning of June 2019. The samples were identified according the morphological and microscopically characteristics of the colonies after culturing on number of culture media as well as biochemical tests, molecular identification were also used as a final confirmed diagnostic test for isolates that were diagnosed as K.pneumoniae bacteria based on the blaTEM, blaSHV and blaCTX-Mgenes which has specific sequences for K.pneumoniae bacteria as a detection gene and also consider as virulence factor so it have a synonyms mechanism to antibiotic resistance. The results of the final diagnosis showed that 38 isolates belong to target bacteria, The examination of the sensitivity of all bacterial isolates was done for selected these isolates towards 16 antibiotics by aVitek2 compact ASTN system and the isolates were resistant for a number of antibiotics used such as; Amikacin (5.26%), Imepenem (5.26%), Ertapenem (7.89%), Meropenem (10.52%), Gentamicin (21.05%), Ciprofloxacin (26.32%), Cefoxitin (39.47%), Trimethoprim/Sulfamethoxazole (50%), Ceftriaxone (52.63%), Fosfomycin (55.26%), Piperacillin/Tazobactam (57.89%), Nitrofurantoin (57.89%), Ceftazidime (65.79%), Cefuroxime (71.05%), Cefixime (73.68%) and Ampicillin (100%). The presence of Extended Spectrum Beta-Lactamase genes in 38 K.pneumoniae isolates were 65.8 % of the ESBL genotypes expressed blaSHV genes followed by 52.6 % blaTEM and 42.1 % for blaCTX-M.

The present study included the collection of 121 samples from MSU for investigating the presence of K.pneumoniae in UTIs, the samples have been collected from Al-Shaheed Mohammed Baqir AL-Hakeem hospital and private laboratories in Baghdad province. The study was carried out through March 2019 to the beginning of June 2019. The samples were identified based on the morphological and microscopically characteristics of the colonies when they were culturing on number of culture media as well as biochemical tests, molecular identification were also used as a final diagnostic test for isolates that were positive as they belong to K.pneumoniae bacteria during previous tests based on the blaTEM, blaSHV and blaCTX-M genes which has specific sequences for K.pneumoniae bacteria as a detection gene and also consider as virulence factor so it have a synonyms mechanism to antibiotic resistance. The results of the final diagnosis showed that 38 isolates belong to target bacteria, The examination of the sensitivity of all bacterial isolates was done for selected 38 isolation towards the 16 antibiotics by a Vitek2 compact ASTN system and the isolates were resistant for a number of antibiotics used such as; Amikacin (5.26%), Imepenem (5.26%), Ertapenem (7.89%), Meropenem (10.52%), Gentamicin (21.05%), Ciprofloxacin (26.32%), Cefoxitin (39.47%), Trimethoprim/Sulfamethoxazole (50%), Ceftriaxone (52.63%), Fosfomycin (55.26%), Piperacillin/Tazobactam (57.89%), Nitrofurantoin (57.89%), Ceftazidime (65.79%), Cefuroxime (71.05%), Cefixime (73.68%) and Ampicillin (100%). The presence of Extended Spectrum Beta-Lactamase genes in 38 K.pneumoniae isolates were 65.8 % of the ESBL genotypes expressed blaSHV genes followed by 52.6 % blaTEM and 42.1 % for blaCTX-M.