Frequency and Antibiotic Resistance Profile of Uropathogens Associated With Community Acquired Urinary Tract Infections

Abstract

Abstract Background Community acquired urinary tract infections (CAUTIs) are among the most common bacterial infections diagnosed in community health practice resulting in high rates of morbidity and high economic costs associated with its treatment. CAUTIs are usually treated empirically. Geographical variations in etiologic agents and their antibiotic sensitivity patterns are common. Knowledge of antibiotic resistance trends is important for improving evidence-based recommendations for empirical treatment of UTIs. Adequate empirical treatment can cause decrease in unnecessary hospital stays, treatment cost, antibiotic side effects as well as reducing antimicrobial resistance spread. Aim of the Work To determine the implicated uropathogens associated with community-acquired UTIs and their respective antimicrobial resistance pattern to improve the efficacy of empirical treatment of this infection. Patients and Methods This a cross-sectional descriptive study conducted from November 2018 to November 2019 at the main Microbiology Lab in Clinical Pathology Department, Ain Shams University Hospitals. Samples were received from patients attending different outpatient clinics in Ain Shams University Hospitals having UTI symptoms and whose urine samples showed significant bacterial growth (≥105 CFU/mL) associated with pyuria (more than 8–10 pus cells by microscopic urine analysis) and nitrite and leukocyte esterase positive by chemical analysis of urine strip. Results A total of 1600 patients who fulfilled our inclusion criteria were sampled. Of these, 1058 patients had urine samples that showed significant bacterial growth while about 34% of the samples were contaminated and excluded . Of the 1058 significant samples, 764 (72.21%) were from females and 294 (27.79%) from males with female to male ratio 2.6:1. Escherichia coli was found the dominant bacteria among a with the prevalence rate of 24.4% followed by Klebsiella pneumoniae (13.8%). Tetracycline was found the most resistant antibiotic 929 (95.4%) followed by Ampicillin, Tazobactam-piperacillin, and Ampicillin- sulbactam by 90.1%, 81.7% and 77.7% respectively; however, the most sensitive antibiotics against all uropathogens were Carbapenems (Ertapenem 72.9% fol Imipenem 66.5% and Meropenem 66.4%) followed by Nitrofurantoin and Amikacin showing 64.3% and 58.01% sensitivity respectively . However, For gram positive uropathogens, Linezolid showed the highest sensitivity in 84% of the isolates. Conclusion The present study reveals a familiar pattern with respect to the species of uropathogens involved in community acquired urinary tract infections, however with considerable bacterial resistance to common empirically prescribed antibiotics.