Antimicrobial Resistance in Uropathogenic Escherichia coli Strains Isolated from Relapses from Recurrent Urinary Tract Infections.

Little is known about the characteristics of uropathogenic Escherichia coli (UPEC) associated with recurrent urinary tract infections (RUTIs). The present study aimed to analyze the phenotypic antimicrobial resistance of recurrent UPEC isolates attributable to either relapse or reinfection. A total of 140 E. coli strains were isolated from 70 outpatients with RUTIs. All isolates were analyzed by random amplified polymorphic DNA-polymerase chain reaction to evaluate genetic similarity between the first and second isolates. We found that 64.2% (45/70) of outpatients had a relapse with the primary infecting E. coli strain and 35.7% (25/70) had reinfection with a new E. coli strain. Compared with reinfecting strains, relapse UPEC isolates exhibited much higher antimicrobial resistance; 89% of these isolates were multidrug-resistant and 46.6% were extended-spectrum ß-lactamase producers. Our study provides evidence that RUTIs are mainly driven by the persistence of the original strain in the host (relapses) despite appropriate antibiotic treatments, and only RUTIs attributed to relapses seem to favor multidrug resistance in UPEC isolates.

The Short-Term Effects of Roux-en-Y Gastric Bypass on Renal Excretion of Sodium and Its Association with Blood Pressure.

INTRODUCTION: Bariatric surgery has been shown to be effective in reducing weight and has benefits, such as lowering blood pressure. An increase in urinary sodium excretion has been suggested as a possible mechanism. This study explored changes in sodium excretion and their correlation with blood pressure after Roux-en-Y gastric bypass. MATERIALS AND METHODS: This study was conducted on 28 obese participants with body mass index (BMI) of 44.54 ± 7.81 kg/m2 who underwent gastric bypass. Before surgery and at the third and sixth months after gastric bypass, blood pressure, urinary sodium concentration, 24-hour (24-h) urinary sodium excretion, and fractional excretion of sodium were evaluated. In addition, serum sodium and potassium levels were determined. Nonparametric tests were used to analyze the data. RESULTS: Blood pressure decreased after surgery and remained at low levels over the 3- and 6-month periods. The urinary sodium concentration increased at 3 months after surgery; however, the 24-h urinary sodium excretion and urine volume decreased. Interestingly, although some associations between variables were observed, significant correlations between the 24-h urinary sodium excretion and the systolic, diastolic, and mean blood pressures were found. In addition, the urine volume was higher in the sixth month than in the third month following surgery. CONCLUSIONS: In the months immediately following surgery, a low-salt and low-volume diet favors decreases in urine volume and 24-h urinary sodium excretion. In addition, in the sixth month after surgery, an association between blood pressure and 24-h urinary sodium excretion was observed.

Identification of virulence factors genes in Escherichia coli isolates from women with urinary tract infection in Mexico.

E coli isolates (108) from Mexican women, clinically diagnosed with urinary tract infection, were screened to identify virulence genes, phylogenetic groups, and antibiotic resistance. Isolates were identified by MicroScan4 system; additionally, the minimum inhibitory concentration (MIC) was assessed. The phylogenetic groups and 16 virulence genes encoding adhesins, toxins, siderophores, lipopolysaccharide (LPS), and invasins were identified by PCR. Phylogenetic groups distribution was as follows: B1 9.3%, A 30.6%, B2 55.6%, and D 4.6%. Virulence genes prevalence was ecp 98.1%, fimH 86.1%, traT 77.8%, sfa/focDE 74.1%, papC 62%, iutA 48.1%, fyuA 44.4%, focG 2.8%, sfaS 1.9%, hlyA 7.4%, cnf-1 6.5%, cdt-B 0.9%, cvaC 2.8%, ibeA 2.8%, and rfc 0.9%. Regarding antimicrobial resistance it was above 50% to ampicillin/sulbactam, ampicillin, piperacillin, trimethoprim/sulfamethoxazole, ciprofloxacin, and levofloxacin. Uropathogenic E. coli clustered mainly in the pathogenic phylogenetic group B2. The isolates showed a high presence of siderophores and adhesion genes and a low presence of genes encoding toxins. The high frequency of papC gene suggests that these isolates have the ability to colonize the kidneys. High resistance to drugs considered as first choice treatment such as trimethoprim/sulfamethoxazole and fluoroquinolones was consistently observed.

[Somatic, biochemical and arterial pressure at the end of adolescence, according to weight at birth]. / Diferencias somáticas, bioquímicas y de presión arterial al finalizar la adolescencia, según el peso al nacer.

OBJECTIVE: To investigate in young people differences among somatic measurements, biochemical issues and arterial tension, according to weight at birth. MATERIAL AND METHODS: 53 youth born with body weight <2500 g, and 100 born with normal weight were studied. VARIABLES: somatic measurements, arterial pressure, glucose, insulin, cholesterol and triglycerides. Insulin resistance and metabolic syndrome were also evaluated. RESULTS: Men born with normal weight had higher cholesterol and resistance to insulin. Differences persisted for odds ratio. Those born with <2500 g had a negative correlation among weight at birth and glucose level. Overweight-obesity was found in 30.0% (46/153) and the metabolic syndrome in 10% (14/140); the frequency of this syndrome increased with the IMC was higher: from 2.0% (2/100) in eutrophics to 30% (12/40) in those with overweight-obesity. CONCLUSIONS: The findings stand out the magnitude of the adiposity and of the metabolic syndrome in youths.

Diferencias somáticas, bioquímicas y de presión arterial al finalizar la adolescencia, según el peso al nacer / Somatic, biochemical and arterial pressure at the end of adolescence, according to weight at birth

Objetivo: Investigar las discrepancias somáticas, bioquímicas y de presión arterial según el peso al nacer. Material y métodos: Se estudiaron 53 jóvenes que nacieron con peso < 2500 g y 100 jóvenes con peso normal. Variables: somatometría, presión arterial, y concentraciones en suero de glucosa, insulina, colesterol y triglicéridos. Se estudió la presencia de resistencia a la insulina y de síndrome metabólico. Resultados: Los varones nacidos con peso normal tuvieron mayor colesterol en suero, pliegue tricipital y resistencia a la insulina. Las diferencias en resistencia a la insulina persistieron por razón de momios. En los de peso bajo al nacer, a menor peso mayor concentración de glucosa. Se encontró sobrepeso obesidad en 30% (46/153) y síndrome metábólico en 10% (14/140): la frecuencia de éste aumentó con el IMC; de 2% (2/100) en eutróficos a 30 % (12/40) en quienes tenían sobrepeso obesidad. Conclusiones: Los hallazgos resaltan la magnitud de la adiposidad y del síndrome metabólico en jóvenes.

Objective: To investigate in young people differences among somatic measurements, biochemical issues and arterial tension, according to weight at birth. Material and methods: 53 youth born with body weight <2500 g, and 100 born with normal weight were studied. Variables: somatic measurements, arterial pressure, glucose, insulin, cholesterol and triglycerides. Insulin resistance and metabolic syndrome were also evaluated. Results: Men born with normal weight had higher cholesterol and resistance to insulin. Differences persisted for odds ratio. Those born with <2500 g had a negative correlation among weight at birth and glucose level. Overweight-obesity was found in 30.0% (46/153) and the metabolic syndrome in 10% (14/140); the frequency of this syndrome increased with the IMC was higher: from 2.0% (2/100) in eutrophics to 30% (12/40) in those with overweight-obesity. Conclusions: The findings stand out the magnitude of the adiposity and of the metabolic syndrome in youths.