Management of urinary tract infections and antibiotic susceptibility patterns of bacterial isolates

Abstract

Aim of study: Urinary tract infections (UTIs) are among the most common infections affecting individuals of different ages worldwide. Antimicrobial agents are usually the first-line treatment for UTIs, and the use of the prescribed antibiotic is escalating, resulting in increased rates of bacterial resistance and UTI recurrence. The current study aimed to identify the causative bacteria in Jordan, to explore their resistance pattern to antibiotics and to describe drug-related problems (DRPs) associated with UTI management.Methods: This prospective, descriptive study was conducted in two major health institutions in two cities in Jordan over a period of six months. The study population included inpatients and outpatients diagnosed with UTIs. Patients' data were collected directly from patients using data collection sheet and from patients' charts.Results: A total of 273 patients were included, of whom 56.4% were women. Urine cultures were obtained from 81% of the patients. Escherichia coli was the most common causative pathogen (50.6%), followed by Klebsiella pneumonia (10.8%).Extended spectrum beta-lactamase (ESBL) producing E. coli was the most commonly detected organism across all types of UTIs. Ceftriaxone and imipenem/cilastatin were most commonly administered to hospitalised patients, whilst ciprofloxacin and co-triamzaxole were the most commonly prescribed in outpatient clinics. The susceptibility results for parenteral antibiotics showed high rates of resistance to cefazolin and ticarcillin. Additionally, high rates of resistance to fluoroquinolones were identified. Further, several DRPs were identified. High rates of resistance to commonly prescribed antibiotics were detected. DRPs (ie, inappropriate antibiotic dosage, unnecessary antibiotic prescribing, inappropriate duration of therapy and prescribing of ineffective antibiotics) were relatively common. Conclusion:The present study highlights the need for clinical pharmacists to manage the high level of drug related problems by providing updated information about proper drug selection, rational drug use and patient education and counselling.

Antibiotic-resistant pathogenic bacterial isolates from patients attending the outpatient department of university of Cape Coast hospital, Ghana: A retrospective study between 2013–2015

“…Again, these UTI isolates exhibited multidrug resistance. The fluoroquinolone antibiotics have been used for the treatment of resistant E. coli in uncomplicated UTIs as a first-line drug in communities that have reported 10-20% resistance to TMP-SMX [60]. However, several studies have reported resistance to ciprofloxacin and ofloxacin [61].…”

Possible scenarios of the development of antibiotic resistance in patients with urinary tract infection after the COVID-19 pandemic era

“…Nowadays, there are many of data about the level of resistance to different antibiotics. Despite on definitive success of antibiotic therapy for the treatment of UTI, antimicrobial resistance remains a main public health problem in the world [14,15]. Among different multidrug-resistant microorganisms (MDM), E. coli is the most common causative pathogen associated with UTI, followed by Klebsiella spp, Enterococcus spp, and other gram-negative bacteria.…”

Urinary tract infections due to multi-drug-resistant bacteria at Mohammed VI University Hospital Center of Oujda-Morocco

“…According to the Infectious Diseases Society of America (IDSA), urinary tract infections (UTIs) are defined as the association of significant bacteriuria, leukocyturia and suggestive clinical symptoms (Nicolle et al, 2019). UTIs are common reasons for consultation in general practice and emergency departments (Amawi et al, 2021). Approximately 150 million UTI episodes are registered yearly worldwide (Stamm and Norrby, 2001).…”