Multidrug Resistance of Uropathogens at Governmental Hospitals in the Gaza Strip/Palestine

Abstract

Urinary tract infection is a public health problem worldwide. E. coli and klebsiella are among the main etiologic for UTI in Gaza Strip. The growing variations in resistance among uropathogens to antimicrobials is multifactorial and varies globally. It greatly reduces/limits or complicate treatment option. Aims: To determine the pattern of antimicrobial resistance and multidrug resistance among uropathogens at governmental hospitals. Methods: We analyzed the data of 11,890 urine samples processed in governmental hospitals in the Gaza Strip, Palestine during 2019. The percentage of resistance was calculated for uropathogens, and then multidrug resistance was calculated according to “CDC” definition. Results: Of 11,890 urine samples, 2910 (24.5%) showed significant growth.  Escherichia coli was isolated most frequently (1743; 59.9%), followed by Klebsiella spp. (725; 24.9%), Pseudomonas spp. (123; 4.2%), Streptococcus spp. (98; 3.4%), Staphylococcus aureus (41; 1.4%). Microorganisms resistance was high against Ampicillin (92.4%) and Amoxicillin (91.1%), Co-Trimoxazole (68.2%), Cefalexin (64.9%), Doxycycline (61.9%), Nalidixic acid (53.6%), Cefuroxime (53.0%), Ceftriaxone (48.9%), Ceftazidime (43.1%), Ciprofloxacin (36.9%), Gentamicin (25.8%), Amikacin (3.2%). The resistance of microorganisms in males is higher than females. Multidrug resistance was detected in 37% of E. coli and 53% in Klebsiella spp. Conclusion: Resistance is high and variable among uropathogens isolated from patients in Gaza strip. Both age and gender are risk factors in both infection and resistance pattern. The multidrug resistance percentage is growing remarkably in Gaza Strip. Keywords: Uropathogens, Resistance, Urinary tract infection, Multidrug resistance, Gaza strip, Palestine