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Urine Antibiotic Activity in Patients Presenting to Hospitals in Laos: Implications for Worsening Antibiotic Resistance

By Manisone Khennavong, Viengmon Davone, Manivanh Vongsouvath, Rattanaphone Phetsouvanh, Joy Silisouk, Olay Rattana, Mayfong Mayxay, Josée Castonguay-Vanier, Catrin E. Moore, Michel Strobel and Paul N. Newton


Widespread use of antibiotics may be important in the spread of antimicrobial resistance. We estimated the proportion of Lao in- and outpatients who had taken antibiotics before medical consultation by detecting antibiotic activity in their urine added to lawns of Bacillus stearothermophilus, Escherichia coli, and Streptococcus pyogenes. In the retrospective (N = 2,058) and prospective studies (N = 1,153), 49.7% (95% confidence interval [CI] = 47.4–52.0) and 36.2% (95% CI = 33.4–38.9), respectively, of Vientiane patients had urinary antibiotic activity detected. The highest frequency of estimated antibiotic pre-treatment was found in patients recruited with suspected central nervous system infections and community-acquired septicemia (both 56.8%). In Vientiane, children had a higher frequency of estimated antibiotic pre-treatment than adults (60.0% versus 46.5%; P < 0.001). Antibiotic use based on patients histories was significantly less frequent than when estimated from urinary antibiotic activity (P < 0.0001)

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Publisher: The American Society of Tropical Medicine and Hygiene
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  1. (1990). Anti biotic activity of natural products: 1. propolis .
  2. (1987). Antibacterial activity in urine examined for urinary tract infection .
  3. (1968). Antibacterial activity of human urine .
  4. (2000). Antibiotic medication and bacterial resistance to antibiotics: a survey of children in a Vietnamese community . Trop Med Int Health 5: 711 –
  5. (2004). Antibiotic resistance conferred by a class I integron and SXT constin in Vibrio cholerae O1 strains isolated in Laos .
  6. (2010). Antibiotic use in Thailand: quantifying impact on blood culture yield and estimates of pneumococcal bacteremia incidence .
  7. (2001). Antimicrobial activity in urine: effect on leukocyte count and bacterial culture results .
  8. (2000). Antimicrobial agents from plants: antibacterial activity of plant volatile oils .
  9. (2010). Antimicrobial Resistance in Developing Countries .
  10. (2005). Antimicrobial resistance in developing countries. Part I: recent trends and current status .
  11. (2007). Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study .
  12. (2006). Antimicrobial self medication for reproductive tract infections in two provinces in Lao People’s Democratic Republic .
  13. (2006). Causes of community-acquired bacteremia and patterns of antimicrobial resistance in Vientiane, Laos .
  14. (2009). Comparison of immunofluorescence assays, for the diagnosis of scrub typhus and murine typhus, using venous blood and finger prick filter paper blood spots .
  15. (1959). Cranberry juice and the antibacterial action of hippuric acid .
  16. (1999). Detection of antimicrobial activity in urine for epidemiologic studies of antibiotic use .
  17. (1977). Detection of bacterial inhibitors in urine and their preliminary identification .
  18. (1996). Do antimicrobials increase the carriage rate of penicillin resistant pneumococci in children? Cross sectional prevalence study .
  19. (2009). Elevated levels of urinary hydrogen peroxide, advanced oxidative protein product (AOPP) and malondialdehyde in humans infected with intestinal parasites . Parasitology 136: 359 –
  20. (1997). Emergence of methicillin resistant Staphylococcus aureus in Laos .
  21. (2010). Enhanced determination of Streptococcus pneumoniae serotypes associated with invasive disease in Laos using a realtime PCR serotyping assay on cerebrospinal fluid .
  22. (1998). Etiological study of diarrheal patients in Vientiane, Lao People’s Democratic Republic .
  23. (1974). Evidence for bladder bactericidal factor .
  24. (1999). Extent of antibiotic use in Taiwan shown by antimicrobial activity in urine .
  25. (2008). Heinimann A ,
  26. (1998). Human beta-defensin-1: an antimicrobial peptide of urogenital tissues .
  27. (1982). Inhibitory substances in urine: an addition to the routine screen .
  28. (2004). Initial stage of hospital contamination with methicillin-resistant Staphylococcus aureus in Lao People’s Democratic Republic .
  29. (2008). Meeting the challenge of antibiotic resistance .
  30. (1984). Methenamine mandelate with acidification: an effective urinary antiseptic in patients with neurogenic bladder .
  31. (1996). Microbiologic assay for detection of antimicrobial agents in urine .
  32. (2009). Molecular characterization of ESBL phenotypes in a collection of E. coli isolates from Laos,
  33. (2005). Outpatient antibiotic use in Europe and association with resistance: a cross-national database study .
  34. (1993). Penicillin-resistant systemic pneumococcal infections in children: a retrospective casecontrol study .
  35. (2010). Performance Standards for Antimicrobial Susceptibility Testing; Twentieth Informational Supplement.
  36. (1998). Pharmacies, self-medication and pharmaceutical marketing in Bombay, India .
  37. (1990). Purchase of antibiotics without prescription in Manila, the Philippines. Inappropriate choices and doses .
  38. (2005). Quantitative colorimetric measurement of residual antimicrobials in the urine of patients with suspected urinary tract infection .
  39. (1965). Quantity and quality in the diagnosis of urinary tract infections .
  40. (2001). Real world pharmacy: assessing the quality of private pharmacy practice in the Lao People’s Democratic Republic . Soc Sci Med 252: 393 –
  41. (1970). Role of bacterial growth inhibitors in urine in diagnostic culture .
  42. (1977). Role of urinary solutes in natural immunity to gonorrhea .
  43. (2006). Self-medication with antimicrobial drugs in Europe .
  44. (1986). Self-prescribing by way of pharmacies in three Asian developing countries .
  45. (1975). Significance of the antibacterial agent assay of urine for bacteriological diagnosis and control of chemotherapy of urinary tract infections .
  46. (1985). Simple microbiological method for the identification of antimicrobial agents prescribed in general practice .
  47. (1999). Socioeconomic and behavioral factors leading to acquired bacterial resistance to antibiotics in developing countries . Emerg Infect Dis 5: 18
  48. (1982). The antibacterial activity of Rowatinex .
  49. (1952). The determination of bacterial sensitivity to antibiotics .
  50. (2004). The etiology of febrile illness in adults presenting to Patan Hospital in Kathmandu, Nepal .
  51. (2010). The infective causes of hepatitis and jaundice among hospitalized patients in Vientiane, Laos . Trans R Soc Trop Med Hyg 104: 475 –
  52. (1995). The Lao National Drug Policy: lesson along the journey .
  53. (1982). The presence of antimicrobial potential in urine samples and its interference in the evaluation of bacteriuria .