Antibiogram profile of uropathogens isolated at Bahir Dar Regional Research Laboratory Centre, Ethiopia

Abstract

IntroductionAntimicrobial resistance among bacteria that cause urinary tract infection (UTI) has been increasing since the introduction of chemotherapy. This study was aimed to assess the types of isolates from patients with UTI and to determine their current antimicrobial susceptibility profile.MethodsA record based retrospective analysis of bacterial uropathogens processed in the period of January 2012 to December 2014 at Bahir Dar Health Research Laboratory Center (BRHRLC) was determined. According to standard microbiological procedures, midstream urine samples were collected and processed with conventional culture and biochemical tests. Isolates were tested against commonly used antibiotics by Kirby-Bauer disc diffusion methods. Chi-square test was calculated to compare the proportion of bacterial isolates between sex and age and statistical significance was set at p value < 0.05.ResultsOut of 446 patients, female constituted at 299 (67%). Significant bacteriuria was reported on 30.5% (95% CI: 26.4-34.9%) cultures. Of these, 78% (95% CI: 71.0-84.7%) were from females. Age and sex were found associated with significant bacteriuria at p=0.046 and p=0.001 respectively. The most commonly identified isolates were Escherichia coli, at 72 (49 %) followed by Klebshella pneumonia at 20 (13.6%) and Pseudomonas aureginosa at 11 (7.5%). The overall antimicrobial susceptibility profile showed that Trimetoprim-sulphamethoxazole, amoxicillin/clavulanate and ampicillin revealed high level of resistance, at 84(66.7%), 61(79.2%), 106(91.4% respectively. Conversely, 64.2-100% sensitivity rate was documented for ciprofloxacin, gentamycin and pepracillin.ConclusionUTI associated with multiple drug resistant bacteria is an important health concern of the study population. Therefore, ongoing surveillance of the types of uropathogens and their up-to-date antimicrobial resistance profile is crucial for better management of patients.

Antibiotic susceptibility patterns of Uropathogenic Escherichia coli among patients with urinary tract infections in a tertiary care hospital in Maiduguri, North Eastern, Nigeria

“…This underscores the fact that many studies have reported highly resistant and have recommended the disbandment of its use as the drug of choice for empirical treatment of UTI management globally. For instance, high rate of resistance against Cotrimoxazole was reported by studies done in India, Brazil, and Iran (Prakash and Saxena, 2013;Jeevan and Zarrin, 2017;Peixoto De Miranda et al, 2014;Rocha et al, 2012;Aghazadeh et al, 2015) and also by other studies done in Ethiopia (Derbie et al, 2017). Nonetheless, reduced susceptibility of E. coli isolates from patients with UTI to Co-trimoxazole varying from (0.00% susceptibility) to (13.90% susceptibility) have been reported by other studies done in different part of Nigeria (Ochada et al, 2014;Oreh and Attama, 2013;Dada-Adegbola and Muili, 2010;Uwaezuoke and Ogbulie, 2006).…”

Analysis of the antimicrobial susceptibility profile of bacteria isolated from urine samples at a hospital in the southeast of Minas Gerais

“…No presente estudo, a maioria das bactérias isoladas foi proveniente de pacientes do sexo feminino (54,7%), corroborando os achados de diversos estudos similares, e explicado anatomicamente. (5,6,(8)(9)(10)(11)(14)(15)(16)(17) A prevalência de identificação nas amostras foi de Klebsiella pneumoniae (18,0%), Escherichia coli (17,6%) e Pseudomonas aeruginosa (9,5%), sendo semelhante à prevalência reportada por Derbie et al, (16) Rezaee et al, (11) Gilani et al, (17) Bitencourt et al (5) e Yoon et al, (6) o que chama a atenção por serem bactérias Gram negativas com grande probabilidade de desenvolverem rapidamente mecanismos de resistência a múltiplos antibióticos. (12) É interessante observar que na maioria dos trabalhos referenciados encontra-se pelo menos um desses microrganismos mais prevalentes como agente principal de ITU, independente da população analisada, o que demonstra a ampla disseminação desses microrganismos.…”

“…(12) É interessante observar que na maioria dos trabalhos referenciados encontra-se pelo menos um desses microrganismos mais prevalentes como agente principal de ITU, independente da população analisada, o que demonstra a ampla disseminação desses microrganismos. (5,6,(8)(9)(10)(11)(14)(15)(16)(17) O coco Gram positivo mais isolado foi o Enterococcus faecalis, mesmo microrganismo descrito no estudo de Rezaee et al (11) e Yoon et al, (6) o que se torna coerente já que o público alvo de ambos também era de pacientes hospitalizados. Entretanto, Haque et al (14) e Reis et al (10) demonstraram como mais prevalente entre os cocos Gram positivos o Staphylococcus saprophyticus, apesar do primeiro trabalhar com amostras hospitalares.…”

“…Já os não fermentadores apresentaram um perfil mais alarmante, sendo apenas 36,4% das cepas sensíveis ao meropenem e 41,6% à gentamicina. Nesse grupo, os antimicrobianos com maior sensibilidade foram piperacilina com tazobactam (66,7%) e colistina (96,0%), resultado similar ao encontrado por Yoon et al, (6) Gilani et al (17) e Derbie et al (16) O perfil de sensibilidade aos antimicrobianos dos Gram negativos mostra-se preocupante considerando que 63,2% dos fermentadores e 100,0% dos não fermentadores apresentaram resistência a pelo menos três classes de antibióticos. Além disso, 31,6% dos fermentadores apresentaram positividade para ESBL, sendo 37,5% das cepas de E.coli e 45,7% das Klebsiella sp.…”

Antibiotic sensitivity pattern for non-beta lactam antibiotics and carbapenems in extended-spectrum beta-lactamase (ESBL) producing uropathogens versus non-ESBL producing uropathogens

“…12,13,14 It is therefore important to determine the antibiotic sensitivity pattern in any particular community in order to select the best empiric antibiotic. It is also necessary to determine the sensitivity patterns of non-beta lactam antibiotics against ESBL and non-ESBL producers in order to prescribe appropriate empiric antibiotic/s.…”