Antimicrobial Resistance pattern in Gram-Negative Uropathogens in Duhok City, Northern Iraq

Abstract

Antimicrobial resistance (AMR) is one of the most dangerous global threats since antimicrobial discovery. The world health organization(WHO) has implemented a program called GLASS to mitigate resistance across the globe. Urinary tract infection(UTI) are the second most common infections and are the most common reason for prescription of antimicrobials, the rise in AMR has caused concerns of UTI Overuse and misuse of prescriptions and decrease of treatment options hence many researches conducted across the globe are on uropathogens resistance rate and trend. This retrospective study was conducted in duhok province of KRI to measure antimicrobial resistance percentages and identify the most common uropathogens. 309 urine samples were collected in a time span of 12 months. Urine samples were collected by clean catch midstream and inoculated on blood and MacConkey agars, Antibiotic sensitivity test (AST) was performed to identify Gram negative uropathogen and its sensitivity pattern. We found out most common Gram negative uropathogen in females were E.coli and Klebsiella pneumonia while in males it was E.coli and Pseudomonas aeruginosa and common Klebsiella pneumonia. E.coli was most resistance to amoxicillin/amp(64.2%) and it was least resistant to carbapenems(6.1%). Klebsiella pneumonia had similar resistant pattern to E.coli. pseudomonas aeruginosa was highly resistant to all antimicrobials, third gen cephalosporins were the highest 95.7%. AMR has risen to concerning levels in duhok and if not controlled would result in simple infections causing death in future we recommend guidelines for control of Overuse, misuse and ease of availability of antimicrobials as a measure to decrease AMR. Continues monitoring should be performed on AMR development in the future.