Antimicrobial Profile of Pathogens Causing Community Acquired Urinary Tract Infection in Ain Shams University Hospitals

Abstract

Background: Community-acquired urinary tract infection (CA-UTI) is considered from the most common bacterial infections that is caused by wide range of Gram positive and Gram-negative bacteria. The increasing antimicrobial resistance and high recurrence rates of this infection threaten to increase the economic burden due to prolonged consumption of antibacterial agents. OBJECTIVE: Is to determine the susceptibility pattern of common pathogens causing CA-UTI in patients attending Ain Shams University Hospitals. Methodology: A total number of 385 midstream urine samples were collected from patients attending Ain Shams University Hospitals and subjected to conventional microbiological work up to isolate pathogens causing UTI. Antimicrobial susceptibility testing was done for isolates and the results were interpreted according to Clinical and Laboratory Standards Institute guidelines 2022. Results: From collected samples, 232 (60.3%) yielded significant growth, while 153 (39.7%) samples yielded insignificant or no growth after 48 hours incubation period. Most of isolated pathogens were retrieved from female patients (70.25%). The most common isolated pathogens were E. coli 105 (45.25%), followed by Klebsiella pneumoniae 45 (19.4%). Most isolates were susceptible to carbapenems and aminoglycosides. Least susceptibility was recorded to penicillin group. Conclusion: CA-UTI is more common in females and is mainly caused by E. coli and Klebsiella pneumoniae. Reporting pattern of Antimicrobial susceptibility of pathogens causing CA-UTI is crucial for better prescription of empirical treatment.

Bacterial Diversity and Antibiotic Resistance Patterns of Community-Acquired Urinary Tract Infections in Mega Size Clinical Samples of Egyptian Patients: A Cross-Sectional Study

“…These results may be attributed to several clinical factors including anatomical differences between both males and females, hormonal effects, behavior patterns, and the female urethra's physiological and anatomical properties [ 13 ]. In agreement with our results, females were more susceptible to UTI than males in Egypt and Portugal [ 11 , 14 ]. Males were less susceptible to UTIs because the male urethra is longer, creating an obstacle that keeps bacteria out of the urinary bladder [ 15 ].…”

“…Both isolates have a high sensitivity to carbapenems, with an average sensitivity pattern of 99.4% for E. coli and 89% for Klebsiella spp. These results are closely comparable to those obtained in Egypt and other nations, where the average sensitivity was 91% for Klebsiella spp and 98.5% for E. coli in Egypt [11], 84% for Klebsiella spp and 98% for E. coli in Turkey [27], and 92% for Klebsiella spp and 94% for E. coli in Taiwan [24]. Amikacin in our study is thought to be the most effective aminoglycoside, showing a sensitivity pattern of 91.7% in Klebsiella spp and 98.7% in E. coli, which is consistent with the results in Taiwan [24], where amikacin showed a sensitivity of 96.9% in Klebsiella spp and 98.8% in E. coli.…”

“…A markedly increased resistance of E. coli and Klebsiella spp to different cephalosporin generations (75% and 69%, respectively) and ampicillin (74% and 81%, respectively) were obtained. Our results were alarming the high resistance pattern of both E. coli and Klebsiella spp towards the commonly used generations of cephalosporins, which were higher than that in other countries, as the average resistant pattern was 60% in another study conducted in Egypt [11], but only 54% in Nepal [23],40% in South Africa [10], and 24% in Taiwan [24]. Moreover, the Egypt national action plan for antimicrobial resistance https://www.who.int/publications/m/item/egypt-national-action-plan-forantimicrobial-resistance reported that the average resistant pattern in hospitalized patients was about 86% for both E. coli and Klebsiella spp.…”

“…Globally, empiric therapeutic options for UTIs are limited by the emergence of multi-drug resistant uro-pathogens which may lead to treatment failures [ 10 ]. The results showed a high prevalence of E. coli and Klebsiella spp in the collected positive cultures isolated from UTI patients (47.19%, and 24.42%, respectively) followed by Enterococcus spp and Candida spp (approximately 8% each) as reported by other studies in different countries including Egypt [ 11 ] and Iran [ 12 ] with the percentage of E. coli (42.25% out of 232 isolates in Egypt, 58.82% out of 64 isolates in Iran) and Klebsiella spp (19.4% out of 232 isolates in Egypt, 19.12% out of 64 isolates in Iran).…”