Antimicrobial Resistance in Bacteria Causing Urinary Tract Infections.

BACKGROUND

Bacteria Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are the main causes of Urinary Tract Infections (UTIs). This research aims to investigate the isolation of etiologic agents from patients with UTIs. In addition, it tries to investigate the incidence of ESBL genes in an etiologic agent.

METHODS

This study included 1,000 positive growth isolates. Accordingly, the predominant pathogens associated with urinary tract infections, i.e., Gram-negative, were the main isolates from UTI patients, including E. coli, K. pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, and Enterococcus faecalis.

RESULTS

Among suspicious cases of urinary tract infections, the results showed that 15.2% of the patients had UTIs, with female patients in the childbearing age group being more affected. E. coli (644; 64.4%) and K. pneumoniae (322; 32.2%) were shown to be more isolated. Among 936 (93.6%) ESBL producing bacteria, 614 (61.4 %) were E. coli, and 32.2% were K. In addition, high resistance was recorded for antibiotics Cefotaxime (85.7 %), Cefepime (85.7%), Ciprofloxacin (83.1%), and Kanamycin (77.9%). Most ESBL-producing K. pneumoniae were multidrug-resistant (MDR). Besides, nitrofurantoin, gentamycin, and imipenem were the most effective antibiotics against ESBL-producing E. coli isolates.

CONCLUSION

Research shows that high rates of MDR Escherichia coli infections in our hospital were the frequent causes of UTIs. Nitrofurantoin and aminoglycosides were the most beneficial first-line drugs to be prescribed in UTI cases. It is recommended that regular investigations should be carried out on drug resistance in all isolates to formulate helpful antibiotic treatment policies in Iraq. Thus, it is important to determine ESBL prevalence in urine E. coli and K. pneumoniae isolates as it has a great impact on the selection of suitable antibacterial agents. In short, more than half of ESBL producers have Multiple Drug Resistance (MDR).