Susceptibility Profiles of Bacterial Pathogens Causing Community-Acquired Urinary Tract Infections
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Abstract
Introduction: Uncontrolled empirical treatment of urinary tract infections (UTIs) has negative aspect on predicting the emergence of antimicrobial resistance and knowledge of those patterns has become extremely important from time to time. Therefore, the aim of the present study was to check the prevalence and resistance patterns of uropathogens in the community acquired UTIs. Methods: A total of 7132 urine samples were combined from male 3131 (43.9%) and female 4001 (56.1%) outpatients suspected of having UTIs, respectively over a three-year period and cultured on routine culture media. The bacteria have been identified using basic biochemical tests, and sensitivity to various antibiotics was determined by the method of disk diffusion. Results: Of 7132 urine samples 797 (11.2%) yielded significant uropathogens. Among the bacterial species, Escherichia coli was the major causative agent of UTIs for both gender (63.7%), followed by Klebsiella spp (20.8%), Enterococcus faecalis (5.3%), Pseudo- monas spp (4.1%), Proteus spp (3.1%), Enterobacter spp (1.5%), Candida albicans (0.6%), Staphylococcus saprophyticus (0.5%), Providencia spp (0.1%) and Staphylococcus aureus (0.1%). The antibacterial sensitivity testing for E. coli, to commonly used antibiotics were showed variable resistant as follows: Ampicilln (78%), Amoxicillin (71%), trimethoprim sulfamethoxazole (42%), Amox/clav. (14%) gentamicin (20%), nitrofurantoin (11%), nalidixic acid (22%), ciprofloxacin (20%), Imipenem (16%),Ceftazidim (26%),Cefotaxim (25%),Ceftriaxon (21%),Cefuroxim (33%). Conclusions: The findings showed that antimicrobial resistance patterns of uropathogens in variable, and continuous monitoring of resistance patterns by using of antibiotic susceptibility testing in the laboratory is the most appropriate to treat UTIs rather than the choice of UTIs empirical treatment.
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Sujatha R, Nawani M. Prevalence of asymptomatic bacteriuria and its antibacterial susceptibility pattern among pregnant women attending the antenatal clinic at Kanpur. J Clin Diagn Res 2014;8:1–3.
Tania C, Ines L, Ricardo F, Jasmin N, Adelaide A. Frequency and Antibiotic Resistance of Bacteria Implicated in Community Urinary Tract Infections in North Aveiro Between 2011 and 2014. MDR 2017;00:00.DOI: 10.1089/mdr.2016.0318.
Litwin MS, Saigal CS, Yano EM, Avila C, Geschwind SA, Hanley JM, et al. Urologic Diseases in America Project: analytical methods and principal findings. J Urol 2005;173:933—7.
Safar F, Mohammad YA , Reza G , Behrooz N, Ailar N. Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran. ijid 2009; 13: 140—144
Chang SL, Shortliffe LD. Pediatric urinary tract infections. Pediatr Clin North Am 2006;53:379- 400.
Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community- acquired urinary tract infections in J N M C Hospital Aligarh, India. Ann Clin MicrobiolAntimicrob 2007;6:6-4. DOI10.1186/1476-0711-6-4.
Martins F,Vitorino j, Abreu A. Evaluation of antimicrobial susceptibility profile of microorganisms isolated from urine in the Sousa and Tamega valley region. Acta Med Port 2007; 23:641–646.
Shabbir M, Iman NU, Shah, M. Z . Multidrug resistant uropathogens in urinary tract infections and their antibiotic susceptibility patterns. Journal of Medical Sciences. 2018; 26:24-27.
Johnson JR, Berggren T, Manivel JC. Histopathologic microbiologic correlates of invasiveness in a mouse model of ascending unobstructed urinary tract infection. J Infect Dis 1992;165:299—305.
Chika E, Ugwu M, Iroha I, Gugu T, Duru C, Eze P, Esimone C. Detection and antimicrobial susceptibility of some gram negative bacteria producing carbapenemases and extended spectrum β-Lactamases. Journal of Immunology Research.2017; 2:064-069.
Bodmann KF, Heizmann WR, von Eiff C, Petrik C, Lschmann PA, Eckmann C. Therapy of 1,025 severely ill patients with complicated infections in a German multicenter study: safety profile and efficacy of tigecycline in different treatment modalities. Chemotherapy. 2012;58:282–94.
Hooton T, Bradley S, Cardenas D, Colgan R, Geerlings S, Rice J, Saint S, Schaeffer A, Tambayh P, Tenke P, Nicolle L. Infectious Diseases Society of America Guidelines for the diagnosis, prevention, and treatment of catheter-associated urinary tract infections in adults. Clin Infect Dis. 2010; 50: 625-663.
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twentieth informational supplement. Wayne, PA, USA: CLSI; 2010.
Rahul M, Sudhir A, Saroj S, Sanjay C, Kusum H. Urinary tract infections caused by Pseudomonas aeruginosa: A minireview. Jiph 2009; 2: 101—111
Gajdács M, Burián K., and Terhes G. Resistance levels and epidemiology of non-fermenting gram- negative bacteria in urinary tract infections of inpatients and outpatients (RENFUTI): a 10-year epidemiological snapshot, Antibiotics. 2019 ; 8,(3) 143.
Odoki M., Aliero A., Tibyangye J. et al., Prevalence of bacterial urinary tract infections and associated factors among patients attending hospitals in Bushenyi district, Uganda,” International Journal of Microbiology. 2019 ; (1)1-8 (1).DOI: 10.1155/2019/4246780
Yilmaz N, Agus N, Yurtsever SG, Pullukcu H, Gulay Z, Coskuner A, et al. Prevalence and antimicrobial susceptibility of Escherichia coli in outpatient urinary isolates in Izmir, Turkey. Med Sci Monit. 2009;15(11):PI61-5.
Goldstein FW. Antibiotic susceptibility of bacterial strains isolated from patients with community- acquired urinary tract infections in France. Multicentre Study Group. Eur J Clin Microbiol Infect Dis 2000;19(2):112-7.
Daza R, Gutierrez J, Piedrola G. Antibiotic susceptibility of bacterial strains isolatedfrompatien tswithcommunity-acquired urinary tract infections. Int J Antimicrob Agents 200118:211-5.
Francesco M, Ravizzola G, Peroni L, Negrini R, Manca N. Urinary tract infections in Brescia, Italy: etiology of uropathogens and antimicrobial resistance of common uropathogens. Med. Sci. Monit 2007; 13:136–144.
Meier S, Weber R, Zbinden R, Ruef C, Hasse B. Extendedspectrum b-lactamase-producing Gram- negative pathogens in community-acquired urinary tract infections: an increasing challenge for antimicrobial therapy. Infection 2011;39: 333-40.
Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women. Clin Infect Dis 2011;52:103 -20.
Kahlmeter G, Poulsen HO. Antimicrobial susceptibility of Escherichia coli from community- acquired urinary tract infections in Europe. Int J Antimicrob Agents 2012 ;39:45-51.
Moayednia R, Shokri D, Mobasherizadeh S, Baradaran A, Et al. Frequency assessment of b-lactamase enzymes in Escherichia coli and Klebsiella isolates in patients with urinary tract infection. J Res Med Sci 2014; 19:41–45.
Linhares I, Raposo T, Rodrigues A, Almeida A. Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a ten-year surveillance study (2000– 2009). BMC Infect Dis 2013;18:13-19.
Chatterjee N, Ghosh R, Chatterjee M, Chattopadhyay S. Correlation of demographic profile and antibiotic resistance in patients with urinary tract infection attending a teaching hospital in Kolkata. J Med Sci Clin Res 2014; 2:2806–2816.
Nicolle LE. Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urol Clin North Am 2008; 35:1-12.
Cove-Smith A, Almond M. Management of urinary tract infections in the elderly. Trends UrolGynecol Sex Health 2007; 12:31–34.
Bartoloni A, Bartalesi F, Mantella A, Dell’Amico E, Roselli M, et al. High prevalence of acquired antimicrobial resistance unrelated to heavy antimicrobial consumption. J Infect Dis 2014; 189:1291–1294.