Sensitivity of urinary pathogens to antimicrobial therapy in patients from primary health care

Abstract

Objective. The aim of this study was to investigate bacterial etiology of urinary tract infections as well as microbial susceptibility to antimicrobials. Methods. The study was conducted retrospectively on basis of data collected and analyzed during the three-year period (2009-2011) concerning analysis of microbial pathogens of urinary tract infections and their antibiotic susceptibility in microbiology laboratory of the Institute of Public Health of Kragujevac. Microorganisms were identified after cultivating and growth on agar chromogen and susceptibility was tested using antibiotic disk diffusion method on Mueller-Hinton agar (Biomerieux). The results were analyzed by χ2-test, at p=<0.05. Results. From the total of 44559 samples, 14738 (33.1%) were positive to infection. The most frequent isolates were Escherichia coli, Proteus spp, Klebsiella spp, Enterococcus spp and Pseudomonas spp. The most frequently isolated pathogen in women was E. coli (72%), and in men Klebsiella spp (28.3%). Also, decrease in susceptibility to antibiotics was detected in Proteus spp (to aminoglycosides and quinolones), Klebsiella spp (to II and III generation of cephalosporins and quinolones), Enterococcus spp (to doxycycline) and Pseudomonas spp (to III generation of cephalosporins). It was observed that there was an increase in percentage of ESBL strains in Escherichia coli (from 0,08% to 0,62%) and in Proteus spp (from 0, 49% to 4, 14%). Conclusion. Those data indicate global problem concerning antimicrobial resistance development, not just in hospital conditions, but also in the community. Monitoring of circulating bacterial isolates in different life conditions and resistance mechanisms investigation is needed. In line with all these information, the goal is to make appropriate therapeutic protocols.