Are Empirical Treatments Compatible with the Pattern of Antibiotic Sensitivity in Urinary Tract Infections?

Abstract

Considering the importance of empirical antibiotic treatment before obtaining urine culture results, it is necessary to know the pattern of microbial sensitivity to antibiotics to properly manage urinary tract infection (UTI). The present research aimed at determining type of pathogens causing UTI and the pattern of antibiotic sensitivity in urine cultures of hospitalized patients in Hamadan, Iran. This cross-sectional study was conducted on 120 individuals (including 60 cases as hospital-acquired infection and 60 cases as community-acquired infection group). The urine samples were cultured and processed for subsequent uropathogens isolation. The specimens were cultivated on Muller-Hinton Agar (Merck, Germany) and incubated at 37 °C for 24 h. The antibiotic sensitivity was determined using disc diffusion method by antibiogram discs (English MAST Company, recommended by the Clinical and Laboratory Standards Institute (CLSI) guideline) in two groups of outpatients and inpatients simultaneously. According to the results, most isolates were resistant to commonly used antibiotics in the treatment of UTIs. A significant increase was observed in drug resistance to ciprofloxacin, levofloxacin, cotrimoxazole, and ceftriaxone, especially in community-acquired cases. In community-acquired UTIs from the gram-negative pathogen, E. coli showed the highest drug sensitivity to imipenem (100%) and fosfomycin (95%), and the highest drug resistances were observed for ciprofloxacin (62.5%) and levofloxacin (60%). In the cases of E. coli acquired from the hospital, resistance to fluoroquinolones, ceftriaxone, and cefepime increased, while the sensitivity to meropenem, imipenem, and piperacillin-tazobactam was 80.6%, 87.1%, and 90%, respectively. Urinary tract infection was highly prevalent in the study area and all uropathogens isolated developed resistance against mostly used antibiotic.