Bacteria causing urinary tract infections and its antibiotic susceptibility pattern at tertiary hospital in Al-Baha region, Saudi Arabia: A retrospective study

Abstract

A BSTRACT Context: Clinicians face one of the most common bacterial infections in developing countries that is urinary tract infection (UTI). Current knowledge on antimicrobial susceptibility pattern is essential for selecting appropriate therapy. Aims: In this study, we investigated the various bacteria causing UTI and determined the sensitivity and resistance of antibiotics pattern against most prevalent uropathogens isolated from patients at tertiary hospital, Al-Baha, Saudi Arabia. Settings and Design: This was a retrospective study of urine culture conducted in King Fahad Hospital at Al-Baha in Saudi Arabia. Materials and Methods: Laboratory reports and patient medical files of both inpatient and outpatient were collected between June 2017 and May 2018, targeting both male and female of age above 18 years of age, who had been treated for UTI. Results: A total of 349 patients’ urine report was studied to identify the uropathogens. Escherichia coli was the main etiologic agent in community and hospital-acquired infections. The majority of the bacteria was isolated from female (60%), whereas the remaining (40%) was from male. The most common isolates were E. coli, Klebsiella pneumoniae, Enterococcus faecalis, E. coli Extended spectrum beta-lactamases , Pseudomonas , and K. pneumoniae ESBL (these represented 37.82%, 19.20%, 10.89%, 10.32%, 6.59%, and 3.72%, of isolate, respectively). UTI due to E. coli was at a higher rate during summer than during winter. This study showed that ciprofloxacin (20.29%) and cefuroxime (16.14%) are most prescribed medications, followed by ceftriaxone (12.96%) and then tazocin (8.80%). Imipenem, meropenem, amikacin, vancomycin, tigecycline, linezolid, and colistin were highly sensitive for most types of bacteria, but gram-negative bacteria were highly resistant to ampicillin. Gram-positive bacteria showed highly resistance to cefoxitin. Conclusion: The microbial culture and sensitivity of the isolates from urine samples should be carried out as a routine before starting the antimicrobial therapy. Current knowledge of the antibiotic sensitivity/resistance patterns of uropathogens at a particular geographical region is a guiding factor for choosing an appropriate empirical antimicrobial treatment rather than following universal guidelines.

Bacteria Causing Community-Acquired Urinary Tract Infections and Their Antibiotic Susceptibility Patterns in Outpatients Attending at a State Hospital in Turkey

“…The susceptibility of E. coli strains to ampicillin has been reported to range from 11.6% to 28% [12,15], and its susceptibility to fosfomycin ranged from 60% to 98% [7,13,16]. On the other hand, the sensitivity to nitrofurantoin was found to be high in many studies (86.45%-94%) but low (59%) in the study of Kidwai et al [1,7,8,13,15,16].…”

“…Although studies on the antibiotic resistance pattern of all gram-negative growths are limited in the literature, studies on the growth of E. coli and Klebsiella species have been conducted in different centers. The susceptibility of E. coli strains to ampicillin has been reported to range from 11.6% to 28% [ 12 , 15 ], and its susceptibility to fosfomycin ranged from 60% to 98% [ 7 , 13 , 16 ]. On the other hand, the sensitivity to nitrofurantoin was found to be high in many studies (86.45%-94%) but low (59%) in the study of Kidwai et al [ 1 , 7 , 8 , 13 , 15 , 16 ].…”

“…The susceptibility of E. coli strains to ampicillin has been reported to range from 11.6% to 28% [ 12 , 15 ], and its susceptibility to fosfomycin ranged from 60% to 98% [ 7 , 13 , 16 ]. On the other hand, the sensitivity to nitrofurantoin was found to be high in many studies (86.45%-94%) but low (59%) in the study of Kidwai et al [ 1 , 7 , 8 , 13 , 15 , 16 ]. While the sensitivity to gentamicin was reported to be as low as 37%-45.65% in some studies [ 8 , 13 ], it was reported to be higher by Daoud et al and Dash et al, similar to our results (91.3% and 94.1%, respectively) [ 1 , 16 ].…”

“…While the sensitivity to gentamicin was reported to be as low as 37%-45.65% in some studies [ 8 , 13 ], it was reported to be higher by Daoud et al and Dash et al, similar to our results (91.3% and 94.1%, respectively) [ 1 , 16 ]. The sensitivity to trimethoprim-sulfamethoxazole ranged from 42.99% to 71.9% [ 1 , 7 , 8 , 15 , 16 ], while that to ciprofloxacin ranged from 68% to 91% [ 2 ]. In a study conducted in Turkey, high resistance to ciprofloxacin (22.1%) and cephalosporins (cefepime, 23.5%; ceftazidime, 22.5%; and ceftriaxone, 26.3%) was found in outpatients with E. coli growth in cultures, whereas lower resistance to amoxicillin-clavulanate (16.4%) and nitrofurantoin (4.7%) was observed [ 11 ].…”

“…In studies that evaluated the antibiotic susceptibility of Klebsiella strains, Shaifali et al reported an ampicillin susceptibility rate of 54.54% [ 8 ]. In the literature, the rates of susceptibility to fosfomycin, gentamicin, nitrofurantoin, trimethoprim-sulfamethoxazole, and ciprofloxacin were 53%, 50%-54%, 25%-90%, 47%-81%, 53%-100%, respectively [ 2 , 8 , 13 , 15 ]. Rizvi et al reported a 100% rate of susceptibility to fosfomycin [ 7 ].…”