Antimicrobial Susceptibility Pattern of Bacterial Pathogens Causing Urinary Tract Infections in a Saudi Arabian Hospital

Abstract

The study describes the pathogens causing urinary tract infections (UTI) and the antimicrobial susceptibility pattern of health care-associated (HCA) and community-acquired (CA) isolates. Of the total of 3,989 nonrepetitive urinary cultures, 4.7% (n = 188) were HCA and 95.3% (n = 3,801) were CA isolates. Gram-negative organisms totaled 3,607 (90.4%) vs. 9.6% Gram-positive organisms. In CA-UTI, Escherichia coli, Klebsiella pneumoniae and Enterococcus faecalis constituted 66, 11.4, and 5.4%, respectively. HCA-UTI episodes were caused by E. coli (37.8%), K. pneumoniae (14.4%) and Pseudomonas aeruginosa (6.4%). The susceptibility rates of E. coli to ciprofloxacin, trimethoprim-sulfamethoxazole (TMP-SMX), nitrofurantoin and ceftriaxone in HCA and CA isolates were 53.3 and 74.1%, 42.2 and 62.7%, 32.5 and 97.0%, and 62.3 and 92.7%, respectively. Extended-spectrum β-lactamase production was detected in 8.1 and 7.4% isolates, respectively, of CA and HCA isolates of E. coli. CA isolates of K. pneumoniae were more susceptible to TMP-SMX (89.2 vs. 60.4%), ciprofloxacin (92.6 vs. 67.9%) and cefuroxime (93.8 vs. 24.5%) than HCA isolates. The susceptibility of HCA and CA isolates of E. faecalis to penicillin G and nitrofurantoin were 34.8 and 80%, and 78.3 and 93.6%, respectively (p < 0.001). In conclusion, antimicrobial resistance is high to commonly used oral agents, rendering them inappropriate for empirical use.

Assessment of the in vitro Efficacy of the Novel Antimicrobial Peptide CECT7121 against Human Gram-Positive Bacteria from Serious Infections Refractory to Treatment

“…AP-CECT7121 could provide a realistic therapeutic alternative to standard, broad-spectrum antimicrobial therapy, particularly with the emergence of new resistant pathogenic strains such as vancomycin-resistant S. aureus [29] and enterococci [30,31] , and the appearance of vancomycin-resistant [32] as well as metronidazole-resistant [32,33] strains of C. difficile , telithromycin-resistant S. pneumoniae strains [34] and ciprofloxacin-resistant E. coli [35] , which are now causing great clinical concern worldwide.…”

Nitrofurantoin and Fosfomycin Susceptibility Among Outpatient Uropathogens in a Tertiary Care Center in Southern Thailand

“…Our findings are similar to other studies, although the prevalences vary. [9][10][11][12][13] In this research, most cases were complicated UTIs (72.8%), which was related to two factors, male gender (28.1%) and diabetes mellitus (25.9%). This research was performed in a tertiary care center where there was high pathogenic resistance, at 80.9% for ampicillin, 33.9% for ceftriaxone, 50.0% for norfloxacin, and 48.5% to cotrimoxazole, our first line drug, but all the pathogens studied were more than 70.0% susceptible to fosfomycin and nitrofurantoin so this research suggests treating UTIs with these agents.…”

Investigation of Imipenem, Ciprofloxacin, Gentamicin and Co-trimoxazole Resistant Phenotypes in Nosocomial Escherichia coli Strains

“…Dün ya ge ne lin de ise siprof lok sa si ne %5-69, gen ta mi si ne %1.9-64 ve ko-trimok sa zo le %23.5-76 gi bi de ği şen oran lar da di renç bil di ril miş tir. [8][9][10][11][12] Has ta ne le rin yo ğun ba kım üni te le rin de ki hasta lar dan izo le edi len suş lar da da ha yük sek oran da sap tan mak la bir lik te ge nel ola rak GSBL üre ti mi, dün ya nın çe şit li ül ke le rin den de ği şen sık lık ta bil diril mek te dir. E. co li suş la rın da GSBL üre ti mi, Kuzey Ame ri ka' da %3.3-4.7, Gü ney Ame ri ka' da %6.7-25.4, Uzak Do ğu ül ke le rin de %7.9-23.6, Avru pa' da %5.3 ve ül ke miz de ya pı lan ça lış ma lar da ise %13-38 oran la rın da bil di ril mek te dir.…”

“…An cak gü nü müz de En te ro bac te ri a ce a e üye le rin de kar ba pe nem di ren ci ge nel lik le dü şük oran lar da bil di ril me si ne rağ men, ön ce ki yıl la ra gö -re da ha sık bil di ri lir ol muş tur. 16 İmi pe nem di ren ci, ül ke miz de ya pı lan ba zı ça lış ma lar da %0-2, 6,14,15 dün ya ge ne lin de ya pı lan ba zı ça lış ma lar da ise %0-8.8 [8][9][10] ara sın da de ği şen oran lar da bil di ril mek te dir. En te ro bac te ri a ce a e üye si suş lar da kar ba pe nem diren ci hüc re du va rın da ge çir gen li ği nin azal ma sın -dan, kro mo zo mal en zim ler den ya da gü nü müz de ar tan sık lık ta kar şı la şıl dı ğı gi bi plaz mid kay nak lı be ta-lak ta maz lar dan kay nak la na bil mek te dir.…”