Prevalence and Antibiotic Resistance Pattern of Pathogenic Bacteria Isolated From Urinary Tract Infections in Qal’at Saleh Hospital, Iraq

M. Allami, E. Mohammed, Faten Alazzawi, M. Bahreini
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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.
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伊拉克al 'at Saleh医院尿路感染病原菌的流行及耐药性分析
背景:抗生素耐药性在引起尿路感染的病原菌中出现并广泛传播。此外,不断增加的耐药性突出了评估抗生素耐药模式以改进实验性治疗的必要性。本研究的目的是评估引起尿路感染的细菌及其基于地理区域的易感模式。方法:本研究以2018年1月至2019年1月在伊拉克al 'at Saleh医院转诊的门诊患者为研究对象。采用API 20E试剂盒检测病原菌。药敏试验采用纸片扩散法,按照美国临床与实验室标准协会(CLSI)指南进行。结果:216株分离物中革兰氏阴性菌阳性率为12.03%,革兰氏阳性菌阳性率为87.9%。在这项研究中,大肠杆菌被确定为引起uti的主要原因。在所有分离株中,73.61%对3类及以上抗生素耐药。各菌株的药敏和耐药模式显示,阿米卡星和环丙沙星对革兰氏阴性菌的活性最高,万古霉素、阿米卡星和左氧氟沙星对革兰氏阳性菌的活性最高。结论:由于尿路感染治疗中使用的药物普遍存在耐药性,因此难以选择合适的药物治疗尿路感染。尿路感染影响不同年龄组;因此,应该向社区传播足够的知识来预防这些感染。如果无法进行尿液培养,或者无法等待抗生素敏感性试验,阿米卡星和万古霉素可能是治疗尿路感染的最佳候选药物。
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