Antibiotic Resistance Pattern Among Isolated Bacteria from Urinary Tract Infection Patients in the Intensive Care Unit

Abstract

Background: Urinary tract infection (UTI) is one of the most important health care issues with a major role in occurrence of nosocomial infections. Rise in antibiotic resistance rate by UTIs not only lead to morbidity and mortality, but also impose a remarkable financial burden on health care infrastructure. This study was undertaken to evaluate the prevalence of UTIs and identify common microorganisms responsible for infection and their antibiotic resistance profile in our Intensive Care Unit (ICU). Methods: In this perspective cross-sectional study, data from patients admitted to the ICU of two main referral hospitals in Yasouj, Southern-west Iran from 2015- 2016 was collected. Patients were selected in a subsequent manner and were asked to provide a midstream urine sample. Positive cultures were subsequently placed in differential culture medium for the diagnosis of the causative pathogen, while also evaluating with Muller Hinton Agar culture for antibiogram through disc diffusion method, to evaluate the pathogens sensitivity and resistance towards the tested antibiotics. Results: Based on bacterial culture results among a total of 112 obtained urine samples, 100 (89.2%) were negative while 12 (10.8%) were positive, in which the majority were gram-negative (6.25%) and the most frequent pathogen was Escherichia coli (5.3%). All cases of UTI in our population were fully resistant to cephalexin, ampicillin, and amoxicillin. Also, all gram-negative cultures were sensitive to amikacin. There was also no significant association between the antibiogram results with age, gender, and gram results. Conclusion: we report actual data on the resistance patterns of uro-pathogens in a public hospital in Iran. Escherichia coli showed a high prevalence among all UTIs with lower resistance rates to the antibiotics. Resistance to nalidixic acid and trimethoprim-sulfamethoxazole were significantly lower than other oral antibiotics, making both a suitable and cheap alternative for the empirical treatment.