Antimicrobial susceptibility of microorganisms causing Urinary Tract Infections in Saudi Arabia

Abstract

Introduction: Urinary Tract Infections (UTIs) is one of the most common infections worldwide. UTIs remain a challenge to the healthcare system because of the emergence of antimicrobial resistance. The aim of this study is to report the most common UTI-causative organisms associated with the emergence of antimicrobial resistance in Saudi Arabia.
 Methodology: a retrospective cross sectional study of 1918 positive urine culture samples of both gender collected over 9 months (May 2015 to February 2016) from a major tertiary hospital in Riyadh, Saudi Arabia.
 Results: the median age of individuals involved in the study was 43 years, with males constituting 27.7% only of the population. Among cases deemed complicated (81.1%), common causes were diabetes, pregnancy, and immunocompromization, comprising 24.7%, 11.9%, and 10.8%, respectively. 
 Escherichia coli (52%) was the most common uropathogen, followed by Klebsiella pneumoniae (15%), Pseudomonas aeruginosa (8%) Streptococcus agalactiae (Group B streptococcus) (7%), and Enterococcus faecalis (5%). Overall sensitivity studies showed the most highly resistant uropathogen was Escherichia coli (60%) followed by Klebsiella pneumoniae (16%), Pseudomonas aeruginosa (4%) Enterococcus faecalis (3%), and Enterobacter cloacae (2%). Concerning the first defense antibiotics prescribed for UTI, E. coli was most frequently resistant to Sulfamethoxazole/Trimethoprim (47%) followed by ciprofloxacin (34%). K. pneumoniae was most frequently resistant to Sulfamethoxazole/trimethoprim (35%) followed by cefuroxime (30%), while P. aeruginosa to ciprofloxacin (13%).
 Conclusion: Because of a high level of antimicrobial resistance amongst uropathogens in Saudi Arabia, the development of regional and national UTI guidelines is recommended.

Extended‐spectrum beta‐lactamase (ESBL)‐producingEnterobacteriaceaeand urinary tract infections in pregnant/postpartum women: A systematic review and meta‐analysis

“…In one study from France, of nine pregnant patients, five had positive urine cultures and none of them were ESBL producers . The authors of eight studies did not reply …”

Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: A systematic review

“…From these tables we can observe that studies conducted in non-con ict affected countries appeared to be slightly more focused in terms of site of infection under investigation compared to studies conducted in con ict affected countries, where in a substantial proportion of cases the site of infection was not speci ed, or the authors were analysing resistance pro les of bacteria isolated from a miscellanea of specimens. Publication bias was assessed for a sub-sample of ten studies which presented the proportion of ESBL producers among E. coli isolates on urinary samples, six of which were conducted in con ict-affected countries (45,54,59,75,114,159) and four in non-con ict settings (154,155,164,165). Figure 4 shows the funnel plots elaborated on the logarithm of the proportion of ESBL producers amongst E. coli isolates in urine samples in all studies, and in studies conducted in con ict and non-con ict settings separately.…”

Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: a systematic review

“…Publication bias was assessed for a sub-sample of ten studies which presented the proportion of ESBL producers among E. coli isolates on urinary samples, six of which were conducted in conflict-affected countries [45,54,59,75,114,159] and four in non-conflict settings [154,155,164,165]. Figure 4 shows the funnel plots elaborated on the logarithm of the proportion of ESBL producers amongst E. coli isolates in urine samples in all studies, and in studies conducted in conflict and non-conflict settings separately.…”