Bacterial Urinary Tract Infections in North West of Iran: A Cross-Sectional Study (original) (raw)
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Bacterial resistance of antibiotics used in urinary tract infection
Asian Journal of Pharmaceutical and Clinical Research
The antibiotic resistance is a global problem and requires taking measures to combat this growing problem. One example is by quantifying prevalence of resistant pathogens. Our aim was to define the prevalence patterns of resistance to antibiotics among urinary tract infections by carrying out an appreciable survey in the medical laboratories department, Al-Thawra hospital, Sana'a city.The work was performed retrospectively as a cross-sectional descriptive study, gaining the required information from the patient's records in the medical laboratories.The results indicated that Escherichia coli was the most leading cause of urinary tract infections with 107 (52.2%) isolates followed by Pseudomonas aeruginosa with 39 (19%) isolates. Other species were Staphylococcus spp., Klebsiella spp., Proteus spp., and rarely Serratia and α-hemolytic Streptococcus spp.. The resistance pattern observed for these isolates, showed high resistance rates to the β-lactam antibiotic ampicillin and low rates to the aminoglycoside antibiotics gentamicin and amikacin. The resistance rates to trimethoprim-sulphamethoxazole, nalidixic acid and cefotaxim were also high. The uropathogens developed a moderate average resistance rates to ciprofloxacin and nitrofurantoin.
Duhok Medical Journal, 2019
Background:Anti-microbial resistance could be a major public-health problem worldwide and universal endeavors are required to counteract its rise and the moment most common reason for observational antibiotic treatment. Optimal treatment seems diminish mortality and morbidity in surgical patients and play a crucial part in combating the continuous emergencies of expanding antibiotic resistance. The aim of this study is to study the pathogens and their antibiotic susceptibility in urinary cultures to Central laboratory in Duhok City and to study the rationality of antibiotic treatment urinary tract infection. Patients and Methods:One hundred fifty-one UTI urine samples (culture positive) were collected from patient of central laboratory. Identified and isolated bacteria were determined by biochemical tests like Gram staining, Indole, oxidase, catalase, methyl red, Voges-Proskauer, citrate utilization, hemolysis, motility; and urea; fermentation and utilization tests of glucose, lactose and sucrose. Sensitivity pattern of isolates was determined against some traditional and conventional antibiotics. Results:Staphylococcus aureus was the most common bacteria (40.4 %) followed by E.coli (31.8%). The overall levels of resistance to commonly used antibiotics were moderate in all pathogens. Amikacin and Nitrofurantoin were generally the antibiotics with lowest rates of resistance. Aminoglycosides and Fluoroquinolones were the most often used antibiotics. In first-line treatment, only 55 % of cases were given at least one antibiotic to which the bacteria were sensitive. A statistically significant higher resistant to both Amoxicillin and Erythromycin were found in cultures from UTI patients (P = 0.02 and P = 0.002). Conclusions:Commonly encountered bacteria in this study which are Staphylococcus, Escherichia coli and Klebsiella were found to be highly sensitive to Nitrofurantoin, Amikacin and, to lesser extent, to ciprofloxacin, while low sensitivity pattern was recorded against Amoxicillin and Gentamicin, pointing to that antibacterial misuse is the leading cause for their resistance. The most commonly prescribed antibacterial Trimethoprim.
Urinary tract infection (UTI) is the most common problem in hospitalized and outdoor patients. It is mainly found in females because of the shortness of the urethra and closeness to anus, which facilitate entrance of fecal micro–flora to urinary tract. Aim of the study was to investigate the bacterial uro-pathogens and their antibiotic susceptibility in a tertiary care hospital, Peshawar, Pakistan. Urine samples (n = 200) were analyzed and cultured on cysteine lactose electrolyte deficient (CLED) medium. All the bacterial isolates were identified by conventional biochemical tests. Of the total, bacteria were isolated from 113 patients. In positive samples, 36 (31.9%) were male and 77 (68.1%) were female, whereas, 80 (70.8%) were hospitalized and 33 (29.2%) were walk in patients. E. coli was the dominant uro-pathogen 77 (68.1%) followed by Staphylococcus aureus 13 (11.5%), Proteus spp. 9(8.0%), Pseudomonas spp. 6 (5.3%), Klebsiella spp. 4(3.5%), and methicillin resistant Staphylococcus aureus 4 (3.5%). Antibiotic susceptibility test was performed by disc diffusion method according to clinical laboratories standard institute (CLSI). Bacterial isolates showed resistance to ampicillin (72.0%), ciprofloxacin (53.1%), norfloxacin (51.3%) and trimethoprim–sulfamethaxozole (53.1%). Bacterial spp. resistant to other antibiotics was also prevalent. Meropenem was the most effective antibiotic against all the bacterial isolates. In conclusion, high incidence of single and multiple antibiotic resistant bacterial strains is ma Key Words: Urinary tract infection, Multi drug resistant, E. coli
AJPCR, 2020
Objectives: Urinary tract infection (UTI) is one of the diseases with a highest prevalence in the world. This study evaluated the antibiotics resistant and the prescription pattern for UTI with the aim to participate as an effective monitoring study that enhances rational antibiotics' prescription. Methods: We conducted a retrospective cross-sectional study at King Fahad Specialist Hospital from May 2018 to January 2019. We included a total of 306 patients with UTI. 204 patients diagnosed clinically and empirically treated (Group A), 102 patients underwent urine for culture and sensitivity tests (Group B). Results: UTI showed higher occurrence in female in both Groups A (61%) and B (65%). The mean age was higher in Group B (55.8 years) than Group A (39.44 years). The most commonly prescribed antibiotics for UTI were Trimethoprim + Sulfamethoxazole (TMP+SMX) (56%) and ciprofloxacin (15%). Escherichia coli was the most commonly isolated organism (36.3%) followed by Klebsiella pneumonia (30%). Although 41.17% of organisms were sensitive to TMP+SMX, 38.2% were resistant to it. The organisms were sensitive to amikacin in 80.4% and to gentamicin in 61.8% whereas, 61.8% were resistant to ampicillin. Luckily, no resistance was reported neither for nitrofurantoin nor for vancomycin. Conclusion: The study showed significant resistance to the commonly prescribed TMP+SMX and ciprofloxacin compared to absolute sensitivity to the less prescribed nitrofurantoin. This necessitates special consideration for local susceptibility in empirical therapy.
Comparison of Antibiotic Sensitivity of Prevalent Bacteria
Urine specimens collected from in-patients and outpatients in Urmia Imam Hospital, northwest Iran, were cultured on blood agar and Eosin Methylene Blue agar. Isolated bacteria were identified according to standard microbiological tests and then subjected to sensitivity testing according to routine method of disk agar diffusion technique. Out of 8044 and 10425 urine specimens, 8.7% and 11.9% were identified as having urinary tract infection (UTI) in 2002 and 2006, respectively. The most prevalent bacteria belonged to enterobacteriaceae family and in the case of total susceptibility the upmost resistance was recorded against trimethoprim-sulfamethoxazole (62%) and gentamicin (50%) in 2002, and increased to 69% and 57% in 2006, respectively. The least resistance recorded was to ceftizoxim as 15.6% and 16.8 % in 2002 and 2006, respectively. Antibiotics susceptibility of in-patients was significantly lower than that of outpatients and this was more obvious for cephalosporins. Our findings show a remarkably high prevalence of resistance to the majority of commonly used antibiotics in UTIs, with a decreasing trend in their activities which probably is due to the high rate of antibiotics use in Iran as the first reason. Results of the present study underline the need for sensitivity tests prior to antibiotic therapy in UTI, which could help and guide in proper choosing of antibiotics and effective treatment and, therefore, prevention of antibiotic resistance.
Assessment of multidrug resistance in bacterial isolates from urinary tract-infected patients
Journal of Radiation Research and Applied Sciences
The emerging threat of multi-drug resistance (MDR) in a wide range of diseases is a major public health problem, which prolongs treatment, imposes disabilities and reduces the expected life span. MDR is common in urinary tract infections (UTI). Due to recent dramatic change in antimicrobial activity spectrum, we evaluated the current spectrum of antimicrobials activity in UTIs. We observed 33% infection rate in cultures and positive cultures were followed by the Kirby-Bauer technique for sensitivity testing. We evaluated that females are 3.71 folds more infected than males. We observed Escherichia coli (E. coli) as the most frequent and Pseudomonas aeruginosa (P. aeruginosa) as the least (9.1%). Further, we noted that E. coli infection in males is 4.75 times of males. Moreover, Klebsiella pneumoniae (K. pneumoniae) and E. coli are 2.33 and 7.67 times more prevalent than P. aeruginosa respectively. Our sensitivity results indicate that E. coli and K. pneumoniae are resistant to the most tested antimicrobials. However, P. aeruginosa is susceptible to only few of the tested drugs which include Amikacin, Piperacillin+Tazobactam (in combination), and Ceftriaxone. We conclude, due to MDR strains we need to imitate the current strategies and propose neoadjuvant and other therapies like applied in cancer.
Introduction: Non-critical and irrational use of antibiotics is the most important reason for the ever faster development of infectious diseases causative agents' resistance to those drugs. The aim of this study was to determine the most frequent bacterial causative agents of urinary infections and their resistance to antibiotics. Methods: The study was carried out in the Microbiological Laboratory of the Institute for Public Health of Canton Sarajevo, during the period of January-March 2007, 2008, and 2009. The identification of the causative agents was conducted with classical biochemical series and the sensitivity test to antimicrobial drugs with the disc-diffusion method. The CLSI protocols that precisely define the kind of antibiogram discs used for particular bacteria were used. Results: The most common causative agents of urinary infections were Escherichia coli, Gr. Klebsiella-Enterobacter, Proteus mirabilis and Pseudomonas spp. The highest prevalence of the studied infections was at the age of 71-90 years for all four bacterial species. Women are more exposed to E. coli and Proteus mirabilis infections, and men to Pseudomonas spp. infections. The highest resistance of E. coli was to ampicillin and to trimethoprim+sulfomethoxazole, and the least towards cefixime. For Proteus mirabillis, there was significantly more nonresistant strains than resistant ones to all tested antibiotics except to nitrofurantoin. The least was shown in case of cefixime and gentamicin. Gr. Klebsiella-Enterobacter showed generaly high resistance towards all antibiotics, the least to gentamicin. Documented resistance of Pseudomonas spp. to all antibiotics was also very high.
Iberoamerican journal of medicine, 2021
Introduction: Urinary tract infections (UTI) are one of the most common human bacterial infections encountered by physicians. The risk of resistant microbes is emerging as a result of the overuse of antibiotics treatments. The presence of pathogens with increased resistance to antimicrobial agents makes UTIs difficult to treat. This study was aimed at determining the prevalence of the pathogens that cause UTIs, as well as the antibiotic susceptibility of these isolates. Materials and methods: This prospective study was conducted from February 2020 to April 2020; a total number of 200 urine samples were collected from patients who daily attended TMC Libya. Bacterial pathogens were determined by bacteriological culture methods and Antimicrobial susceptibility testing was done by using the disc diffusion method. Results: Out of 200 samples, 110 cases had a positive culture. The dominant bacterial pathogens were Gram-negative that being with Escherichia coli (49, 55.68%), followed by Klebsiella pneumonia (18, 20.46%), Pseudomona aeruginosa (9, 10.23%), Proteus mirabilis (8, 9.09%), Enterobacter aerogenes (2, 2.27%), Citrobacter freundii (2, 2.27%). Gram-positive bacteria were Staphylococcus aureus 20 (90.91%) followed by S. saprophyticus (2, 9.01%) of the isolate's strains. The isolated uropathogen showed increased levels of resistance to antibiotics. Where the Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus indicated the highest antibiotic resistance to Nitrofurantoin, Sulfamethoxazole/trimethoprim, Tetracycline, Ciprofloxacin, Metronidazole and also revealed the most sensitivity to Cefixime followed by doxycycline and ceftriaxone. Conclusions: The obtained results emphasized the emergence of highly resistant bacteria to most of the tested antimicrobials and propose the need for physicians to change their treatment pattern depending on antimicrobial susceptibility results.
A prospective study on antibiotic resistance pattern in patients with urinary tract infection
International Journal of Basic & Clinical Pharmacology
Background: Antibiotics are a blessing to the mankind in the realm of medical treatment. Quite contrary to that fact, they may cause risks in medical treatments of patients if these antibiotics are not taken under medical guidelines. In the current scenario it is a huge challenge for selecting appropriate antibacterial agents for the treatment of UTI. This study aims to evaluate the prescription & resistance pattern of antibiotics in patients with urinary tract infection. Methods: A prospective observational study was carried out for a period of 1 year. Data on 100 research participants' reports and the results of their tests for antibiotic resistance were taken from the microbiology department's records, evaluated, and represented as percentages. Observations were made and meticulously recorded. Results: Out of 100 study participants, Escherichia coli was the most common pathogen with a total of (35%) followed by Klebsiella (17%), Enterococcus with (16%). E. coli were highl...
International Journal of Preventive Medicine, 2019
Background: Urinary tract infection (UTI) is one of the most common infectious diseases ranking next to upper respiratory tract infections. UTIs are often significantly associated with morbidity and mortality. The inappropriate administration of antibiotics to treat these infections increased infection resistance to antibiotics. The aim of this study is to determine the frequency of antibiotic resistance pattern in UTIs. Methods: We searched several databases including PubMed, Web of Science, Scopus, Google Scholar, Iran Medex, Magiran, IranDoc, MedLib, and Scientific Information Database to identify the studies addressing antibacterial resistance patterns of the most common uropathogenic bacteria in UTIs in Iran. A total of 90 reports published from different regions of Iran from 1992 to May 2015 were involved in this study. Results: It is shown that the most common pathogen causing UTIs is Escherichia coli with 62%. The resistance among the isolates of E. coli was as follows: ampicillin (86%), amoxicillin (76%), tetracycline (71%), trimethoprim-sulfamethoxazole (64%), cephalexin (61%), and cefalothin (60%). The highest sensitivity among isolates of E. coli was as follows: imipenem (86%), nitrofurantoin (82%), amikacin (79%), chloramphenicol (72%), and ciprofloxacin (72%). Conclusions: The results of this study showed that the most common resistance are antibiotics that are commonly used. The most effective antibiotics for E. coli were imipenem, nitrofurantoin, amikacin, chloramphenicol, and ciprofloxacin. Considering this study, it had better, use less gentamicin, second-generation cephalosporins, and nalidixic acid in the initial treatment of infections caused by E. coli, and no use penicillins, tetracyclines, cotrimoxazole, and first-generation cephalosporins.