Etiology and Antibiotic Susceptibility Patterns of Community-Acquired Urinary Tract Infections in a Kuwait Hospital

Abstract

Objective: The aim of this study was to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from patients with community-acquired urinary tract infections (UTIs) at the Infectious Diseases Hospital, Kuwait. Materials and Methods: The study was conducted over a 7-year period. Patient information was obtained from medical record files. Antibiotic-sensitivity testing was performed by disk diffusion. E test and double disk diffusion methods were used to study the production of extended spectrum β-lactamases. Results: Of the 14,042 urine samples processed, significant bacteriuria (>10⁵ cfu/ml) was detected in 1,606 (11.4%). The majority (74.5%) of the isolates were from women while the remaining 25.5% were from men. The majority of infections (75%) were due to Enterobacteriaceae, coagulase-negative staphylococci (10.3%) and group B streptococci (8.7%). Among the gram-negative enteric bacilli high prevalence of resistance to ampicillin, amoxicillin/clavulanic acid, cephalothin, and trimethoprim/sulfamethoxazole was observed. Increasing resistance to ciprofloxacin and gentamicin was observed in E. coli isolates over the 7 years. Multiple resistance was detected in 53.8 and 41% of E. coli and Klebsiella spp. strains, respectively. No glycopeptide-resistant enterococci were isolated. Conclusion: This study revealed that Enterobacteriaceae were the predominant bacterial pathogen of community-acquired UTIs in Infectious Diseases Hospital, Kuwait. It also demonstrated an increasing resistance to ciprofloxacin, gentamicin and the production of extended spectrum β-lactamase among UTI pathogens in the community.

Emergence of multidrug resistant and extensively drug resistant community acquired uropathogens in Dhaka city, Bangladesh.

“…coli remain the leading uropathogen being responsible for 60% of community acquired UTIs in our area which are in accordance with other studies 18,19,20,21 . It is documented that UTI is more common in females than in males and findings of our investigation are also in agreement with this generalization 22 .…”

Clinical, Etiology and Antibiotic Susceptibility Profiles of Community-Acquired Urinary Tract Infection in a Baghdad Hospital

“…In a study done in Aligarh, India, Klebsiella was isolated in 22% of cultures of 920 patients with CAUTI. In our study the Klebsiella was third common isolated bacteria (17%) and showed a low degree of sensitivity to most antibiotics tested except an 100% sensitivity to imipenem, 94.1% to amikacin, 82.4% to nitrofurantoin and 58.8% to cefoxitin [15,24].…”

“…The low prevalence of enterococcus (7%) in this study is in agreement with other studies and is consistent with the fact that the patients in this study were outpatients with no indwelling catheters. However in this work enterococcus showed a high degree of sensitivity to most antibiotics testes with 100% susceptibility to amikacin and imipenem except pipracillin, tobramycin, gentamicin, ceftazidime and cefotaxime [15].…”

“…this finding in accordance with other regional studies, as the percentage of UTI proved by urine culture 11.4% in Kuwait at Infection disease hospital, 9.17% in south India and 24.6% in Singapore. This indicates that urine culture is essential for a definitive diagnosis [7,15,16].…”

Clinical, Etiological and Antibiotic Susceptibility Profiles of Community-Acquired Urinary Tract Infection in a Western Hemisphere of Baghdad

“…Enterococcus faecalis can produce UTIs in certain patient populations such as patient with indwelling urethral catheter , complicated UTI or patient received broad-spectrum antibiotics for another infection .The low prevalence of enterococcus (7%) in this study is in agreement with other studies and is consistent with the fact that the patients in this study were outpatients with no indwelling catheters . However in this work enterococcus showed a high degree of sensitivity to most antibiotics testes with 100% susceptibility to amikacin and imipenem except pipracillin , tobramycin , gentamicin , ceftazidime and cefotaxime 15 . Although the other species (Proteus 1%, Strept spp 1%, Pseudomeras areogenosa 2%, Al caligenes faecalis 1%, Acienato bacter 1% and Aremonas salmonicida1%) represented a low percentage of isolated bacteria , with good antibiotics susceptibility to most of tested antibiotics , except ciprofloxacin and tobramycin.…”