Prevalence of Isolated Bacteria from Urinary Tracts and Antibiotic Resistance Trend in Peja Region, Kosovo

Background: Urinary tract infections are the most frequent bacterial infections, causing significant morbidity at a high cost of effectiveness. The main purpose of the research was to determine the prevalence and the resistance of gram-negative bacteria in urine samples in the Peja region. Methods and Results: This cohort longitudinal, prospective-retrospective study was conducted in the microbiological laboratories of the regional hospital in Peja and the Regional Centre of Public Health in Peja. The research includes all urine samples tested for gram-negative bacteria from 2018 to 2020. A total of 12,791 urine samples were analyzed in the study, of which 2316 (18.11%) were positive for the growth of gram-negative pathogenic strains, and 10,479 (81.89%) were negative. The most frequently isolated bacteria were E. coli (83.2%), followed by Proteus spp., Klebsiella spp., Acinetobacter spp., and Pseudomonas aeruginosa (5.18%, 4.79%, 2.42% and 2.37% respectively). From the data of our research, we can conclude that E. coli, Proteus spp, and Klebsiella spp. were the three commonly isolated microorganisms in the Peja region. A trend of increased resistance of E. coli to ampicillin was registered from 37.41% in 2018 to 65.58% in 2020; to tobramycin - from 3.68% in 2018 to 5.97% in 2020; to cefalexin from 29.41% in 2018 to 31.09% in 2020; to cefuroxime from 23.7% in 2018 to 28.99% in 2020; to cefotaxime from 21.32% in 2018 to 27.94% in 2020; ceftazidime from 18.84% in 2018 to 27.54% in 2020; to piperacillin from 28.73% in 2018 to 34.97% in 2020; to nitrofurantoin from 5.98% in 2018 to 8.21% in 2020; and to trimethoprim/sulfamethoxazole from 35.56% in 2018 to 42.77% in 2020. In the analyzed period, a trend of the increased resistance of Proteus spp. to ampicillin was registered from 31.43% in 2018 to 81.25% in 2020 and to imipenem from 4.76% in 2018 to 12% in 2020. The resistance rates of Klebsiella spp. strains isolated in 2020 (100% to ampicillin, 5% to amikacin, 38.46% to ofloxacin, 8.7% to imipenem, 33.33% to nitrofurantoin) were higher than those reported in 2018 (87.5%, 2.94%, 34.62%, 6.25%, and 28.21%, respectively). Conclusion: Data from this study can be used to control antibiotic susceptibility trends, create local antibiotic policies, and help clinicians in the rational choice of antibiotic therapy, thereby preventing indiscriminate antibiotic use.