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      The consistency of antibiotic resistance’ results in two methods of disk diffusion and MIC in isolated organisms from patients with urinary tract infections

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          Abstract

          Introduction: The urinary tract infection is the most common infection and drug resistance to it is increasing. Due to the acute infection, the prescribing of medicine is conducted before culture and antibiogram and according to the results, disk diffusion is adjusted. The aim of this study was to compare it with MIC to determine to what extent the current method could be useful.

          Methods: This descriptive cross-sectional investigation research regarding drug resistance was conducted with the help of two methods of disk diffusion and MIC on the isolations of patients’ urine culture with UTI (midstream clean catch). Bacterial resistance was measured, and sensitivity and specificity were evaluated.

          Results: The MIC method was considered the gold standard and, according to the related formula, the sensitivity and specificity of disk diffusion were related to 13 antibiotics obtained as it follows: ciprofloxacin 69% and 69.1% (0.0001 > p and Kappa = .292), cotrimoxazole 50% and 77.3% (p = 0.010), nitrofurantoin 84.7% and 58.2% (0.0001 > p and Kappa = 0.44), ampicilin 83.3% and 85.3% (0.0001 > p and Kappa = 0.33), ofloxacin 65.5% and 83.9% (0.0001 > p and Kappa = 0.429), cephalexin 46.2% and 75.2% (p = 0.012 and Kappa = 0.116), gentamicin 64.2% and 66% (0.0001 > p and Kappa = 0.276), ceftriaxone 27.6% and 80.9% (p = 0.216 and Kappa = 0.074), nalidixic acid 42.1% and 89.2% (0.0001 > p and Kappa = 0.354), imipenem 63.4% and 70.4% (0.0001 > p and Kappa 0.306), co-amoxiclav 83% and 71% (0.0001 > p and Kappa = 0.412), cefixime 21% and 80.9% (0.0001 > p and Kappa = 0.412), vancomycin 55.9% and 94.7 (0.9001 > p and Kappa = 0.532). Sensitivity and specificity of this method were reported to be lower than MIC.

          Conclusions: Due to the low sensitivity and specificity of the disk diffusion method, antibiotic therapy should be certainly considered in clinical conditions, and risk factors for the infection and only by this approach cannot prescribe the drug.

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          Most cited references 10

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          Evaluation of a latex agglutination test (MRSA-Screen) for detection of oxacillin resistance in coagulase-negative Staphylococci.

          The MRSA-Screen (Denka-Seiken, Tokyo, Japan) latex agglutination test was evaluated for its ability to detect PBP 2a from 200 clinical isolates of coagulase-negative staphylococci (CoNS; 84 mecA-positive strains and 116 mecA-negative strains) consisting of 108 Staphylococcus epidermidis, 37 S. saprophyticus, 15 S. haemolyticus, 11 S. hominis, 10 S. capitis, 10 S. warneri, and 3 S. lugdunensis species as well as 6 other species of CoNS. The assay was compared with susceptibility testing with an agar screen plate with oxacillin at 6 microg/ml (OXA6), by oxacillin disk diffusion (DD), by broth microdilution (BMDIL), by the E test, and with Vitek GPS-SV and Vitek GPS-107 susceptibility cards. PCR for the detection of the mecA gene was used as the "gold standard." The sensitivities and specificities for the methods evaluated were as follows: MRSA-Screen, 100 and 100%, respectively; OXA6, 100 and 99%, respectively; DD, 98 and 62%, respectively; BMDIL, 100 and 60%, respectively; E test, 100 and 51%, respectively; Vitek GPS-SV susceptibility card, 98 and 87%, respectively; and Vitek GPS-107 susceptibility card, 100 and 61%, respectively. The MRSA-Screen test accurately and rapidly detected oxacillin resistance in CoNS.
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            Principle & practice of infectious disease

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              Risk factors and bacterial profiles of urinary tract infections in patients with systemic lupus erythematosus.

              Bacteremic urinary tract infection (UTI) is known to carry a high mortality rate, especially in immunocompromised patients. Patients with systemic lupus erythematosus (SLE) have an immunocompromised status, and thus an increased risk of infection. To evaluate the risk factors for UTI in SLE patients and to identify factors associated with bacteremic UTI, we reviewed SLE patients hospitalized for UTI over a 20-year study period. Based on our results we conclude that lupus nephritis is a risk factor for UTI in SLE patients. Clinical symptoms do not significantly distinguish bacteremic from non-bacteremic UTI in hospitalized SLE patients. Although Escherichia coli remain the most common bacteria in UTI, Salmonella spp. might need particular attention because of their high likelihood for causing bacteremia.
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                Author and article information

                Affiliations
                [* ]Infectious Disease Department, Zanjan University of Medical Sciences, Zanjan, Iran
                [** ]Epidemiology Department, Zanjan University of Medical Sciences, Zanjan, Iran
                [*** ]Shahid Beheshti Hospital; Zanjan University of Medical Sciences, Zanjan, Iran
                [**** ]Cardiology Ward, Emam Ali Hospital; Kermanshah University of Medical Science, Kermanshah, Iran
                [***** ]Zanjan University of Medical Sciences, Zanjan, Iran
                Author notes
                Correspondence to: A Karami, Infectious Disease Department, Zanjan University of Medical Sciences, Zanjan, Iran, Zanjan Province, Zanjan, Gavazang Road, Iran, Phone: +989122380951, E-mail: dr.akarami@yahoo.com
                Journal
                J Med Life
                J Med Life
                JMedLife
                Journal of Medicine and Life
                Carol Davila University Press (Romania )
                1844-122X
                1844-3117
                2015
                : 8
                : Spec Iss 4
                : 282-286
                5319302 SIJMedLife-08-04-282
                ©Carol Davila University Press

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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