Abstract

Background: Antibiotic resistance emerged in the pathogens causing urinary tract infections (UTIs) and became widespread. Moreover, increasing drug resistance has highlighted the need to evaluate the antibiotic resistance pattern to improve experimental treatment. The purpose of this study was to evaluate the bacteria causing UTIs and their susceptibility patterns based on the geographical area. Methods: The present study was conducted on outpatients referred to Qal’at Saleh Hospital in Iraq from January 2018 to January 2019. The pathogenic bacteria were detected using API 20E kit. The antimicrobial susceptibility testing was conducted using the disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Results: Of 216 isolates, 87.9% contained gram-negative bacteria and 12.03% contained gram-positive bacteria. In this study, Escherichia coli was identified as the main cause of UTIs. Of all the isolates, 73.61% were resistant to three or more classes of antibiotics. The antibiotic susceptibility and resistance patterns of all isolates showed that amikacin and ciprofloxacin had the highest activity against gram-negative bacteria and vancomycin, amikacin, and levofloxacin had the highest activity against gram-positive bacteria. Conclusions: Due to the widespread resistance to drugs used in the treatment of UTIs, it is difficult to select the appropriate drugs for treating UTIs. UTI affects different age groups; therefore, sufficient knowledge should be transferred to the community to prevent these infections. If urine culture is unavailable, or it is impossible to wait for antibiotic susceptibility testing, Amikacin and Vancomycin might be the best candidates for UTI treatment.

Highlights

  • Antibiotic resistance emerged in the pathogens causing urinary tract infections (UTIs) and became widespread

  • The aim of this study was to evaluate the bacterial species isolated from outpatients with UTI and to determine their antibiotic susceptibility pattern at Qal’at Saleh Hospital in Maysan Governorate, Iraq

  • No sample was found to contain both gram-negative and gram-positive bacteria. in this study, E. coli, P. mirabilis, E. aerogenesis, S. aureus, and E. faecalis were isolated from UTI samples

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Summary

Introduction

Antibiotic resistance emerged in the pathogens causing urinary tract infections (UTIs) and became widespread. The purpose of this study was to evaluate the bacteria causing UTIs and their susceptibility patterns based on the geographical area. Escherichia coli was identified as the main cause of UTIs. Of all the isolates, 73.61% were resistant to three or more classes of antibiotics. The antibiotic susceptibility and resistance patterns of all isolates showed that amikacin and ciprofloxacin had the highest activity against gram-negative bacteria and vancomycin, amikacin, and levofloxacin had the highest activity against gram-positive bacteria. If urine culture is unavailable, or it is impossible to wait for antibiotic susceptibility testing, Amikacin and Vancomycin might be the best candidates for UTI treatment. 10% of reported UTI cases are caused by gram-positive bacteria, including Staphylococcus aureus, Streptococcus agalactiae, and Enterococcus faecalis [6]

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