Antimicrobial resistance patterns of Uropathogens isolated from adult women with acute uncomplicated cystitis

Jamaan Al-Zahrani,Khaled Al Dossari,Saad Abdulrahman Al Shahrani,Ahmed H Gabr,Sameer Al-Ghamdi,Abul-Fotouh Ahmed

doi:10.1186/s12866-019-1612-6

Jamaan Al-Zahrani, Khaled Al Dossari + Show 4 more

Open Access

https://doi.org/10.1186/s12866-019-1612-6

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Abstract

BackgroundTo evaluate the antibiotic resistance patterns of uropathogens isolated from adult women with acute community-acquired (CA) uncomplicated cystitis.ResultsOver a one-year period (May 2015–April 2016), the results of susceptibility testing of outpatient midstream urine samples from 5 different laboratories were prospectively evaluated. The study included only adult women with uncomplicated cystitis. The susceptibility testing in all laboratories was performed using the disk diffusion method with the VITEK-2 Compact system. The isolated uropathogens and their resistance to the tested antibiotics were evaluated. Out of 317 adult women with CA uncomplicated cystitis, 179 had a positive culture. The most commonly isolated organism was Escherichia coli (E. coli) (70.4%), followed by Klebsiella (21.2%). The overall resistance rate was highest for ampicillin (85.6%), followed by cefalotin (56.3%), trimethoprim/sulfamethoxazole (54.7%), pipracillin (51.9%), nitrofurantoin (48.8%) and aztreonam (47.4%). Isolated E. coli strains were commonly resistant to ampicillin (80.5%), trimethoprim/sulfamethoxazole (72.2%) and aztreonam (71.4%), followed by cefalotin (55.9%). The overall ciprofloxacin resistance rate was 17.9%, and the resistent was found only with E. coli (25.4%).ConclusionsOur results may aid in the selection of proper empiric antibiotic therapy for adult women with acute CA uncomplicated cystitis.

Highlights

To evaluate the antibiotic resistance patterns of uropathogens isolated from adult women with acute community-acquired (CA) uncomplicated cystitis
The aim of the study was to identify alternative empiric antibiotic therapies that may be effective against common uropathogens in Riyadh, Saudi Arabia
Only 317 urine samples were from adult women with CA uncomplicated cystitis

Summary

Introduction

To evaluate the antibiotic resistance patterns of uropathogens isolated from adult women with acute community-acquired (CA) uncomplicated cystitis. Acute community-acquired (CA) uncomplicated cystitis accounts for the majority of UTI and community use of antibiotics. Clinicians generally prescribe empiric antibiotic therapy for uncomplicated cystitis and recommend microbial identification and susceptibility testing only in cases of recurrent UTI (rUTI), resistant infections or failure of empiric therapy [5, 6]. The rationale for empiric antibiotic therapy is based on the predictable and narrow spectrum of the causative organisms and their susceptibility patterns. The misuse of antibiotics is the main origin of acquired microbial resistance to commonly prescribed antibiotics. Because of the rise in microbial resistance over time and potential differences in antibiotic susceptibility in different countries, routine assessment of antibiotic susceptibility patterns in different

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