Surveillance of antibiotic resistance among uropathogens in Aljouf region northern Saudi Arabia

Taher, Ibrahim; Almaeen, Abdulrahman H.; Aljourfi, Hassan; Bohassan, Eyad Ahmed A; Helmy, Ahmed; El-Masry, Eman A.; Saleh, Baraka; Aljaber, Nawaf J

doi:10.18502/ijm.v11i6.2218

Cited by 13 publications

(29 citation statements)

References 29 publications

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“…The tested Gram-negative isolates recovered from UTI patients in Ha’il showed great sensitivity to amikacin, and this outcome is matched with data of a similar investigation in Al-Jouf, Saudi Arabia. 39 Accordingly, amikacin is one of the promising candidates to be considered for use as a first-line drug for treating patients with UTIs in Ha’il and Al-Jouf regions of Saudi as well as other areas with similar trends.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Surveillance for Bacterial Uropathogens in Ha’il, Saudi Arabia: A Five-Year Multicenter Retrospective Study

Bazaid

Saeed²,

Alrashidi

et al. 2021

IDR

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Objective Urinary tract infections (UTIs) are among the most common infections that require antibiotic intervention. Antibiotic surveillance programs are crucial to assess resistance patterns of microorganisms associated with UTIs and to tailor antibiotic therapy accordingly. Therefore, the aim of the current study is to investigate the prevalence of uropathogens and their antimicrobial susceptibility patterns in Ha’il region. Methods We conducted a retrospective study in two main hospitals in Ha’il over a 5-year period (January 2015 to December 2019). Laboratory reports and clinical data of patients with a positive urine culture (≥10 5 CFU/mL) were included in the study. Results A total of 428 patients were included in this study. The majority of positive cultures belonged to female patients (94.4%), adults (76.9%) and outpatients (74.3%). Generally, Escherichia coli was the most common pathogen (45%), followed by Klebsiella pneumoniae (17%) and Staphylococcus aureus (12%). Extended-spectrum β-lactamase (ESBL) strains of E. coli (15.7%) and K. pneumoniae (19.7%) showed resistance to most tested antibiotics, while almost all Gram-negative uropathogens including ESBL strains presented low resistance to cefoxitin, imipenem and meropenem. Most strains of Staphylococcus aureus and Enterococcus faecalis were resistant to trimethoprim/sulfamethoxazole including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecalis (VRE), whereas the activity of linezolid was monitored against almost all different strains of Gram-positive uropathogens. Conclusion This surveillance study which was conducted over a 5-year period in the Ha’il region revealed that the most common UTI-associated pathogen was E. coli . Based on the current sensitivity profiles obtained from this surveillance, carbapenems and linezolid can be considered as a first therapeutic choice treating UTIs in Ha’il caused by Gram-negative and positive uropathogens, respectively. Frequent targeted surveillance programs for antibiotic-resistant pathogens and their susceptibility profiles are crucial to enable tailored empirical treatment for patients.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Surveillance for Bacterial Uropathogens in Ha’il, Saudi Arabia: A Five-Year Multicenter Retrospective Study

Bazaid

Saeed²,

Alrashidi

et al. 2021

IDR

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“…The WHO has reported that an estimated 50% of women experience a UTI at some point in their lives [18]. We found 18 papers that studied UTIs in adults, especially in women, as they experienced more infections than men [2,13,18,24,[26][27][28][29][30]32,33,36,40,43,49,55,58,60]. Adult patients were the most represented in all the studies.…”

Section: Uti In Adultsmentioning

confidence: 99%

“…The most commonly isolated organisms were E. coli, followed by Klebsiella spp., P. aeruginosa S. agalactiae, E. faecalis, Streptococcus group B and D, methicillin-resistant Staphylococcus Aureus (MRSA), and vancomycin-resistant E. faecalis (VRE). Some studies even reported a significantly higher prevalence of UTI caused by E. coli among women (p < 0.05) [2,13,18,24,[26][27][28][29][30]32,33,36,40,43,49,55,58,60].…”

Section: Uti In Adultsmentioning

confidence: 99%

“…coli isolates showed a high resistance rate to ampicillin, co-trimoxazole, mezlocillin, piperacillin, trimethoprim, ciprofloxacin, and to cefazolin. On the other hand, they showed a high sensitivity rate to amikacin, ertapenem, nitrofurantoin ciprofloxacin, levofloxacin, moxifloxacin imipenem, meropenem, norfloxacin, and piperacillin/tazobactam [2,13,18,24,[26][27][28][29][30]32,33,36,40,43,49,55,58,60].…”

Section: Uti In Adultsmentioning

confidence: 99%

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Urinary Tract Infections in the Kingdom of Saudi Arabia, a Review

et al. 2023

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Urinary tract infections (UTIs) are among the most common infections and are associated with an increased rate of antimicrobial resistance in Saudi Arabia. Better knowledge of the most common pathogens and their antimicrobial resistance patterns will be useful for creating new treatment guidelines. PubMed, Web of Science, Scopus, and Google Scholar were searched using suitable keywords to identify UTI publications until November 2022. Eligible studies were selected and analyzed. A total of 110 records were found, but only 58 articles were analyzed. Most studies were retrospective, and just a few were cross-sectional or prospective. The majority of the studies were conducted in the central region followed by the Eastern region. Escherichia coli and Klebsiella spp. were the most common pathogens. There was a significant resistance rate against co-trimoxazole and ciprofloxacin. On the other hand, amikacin was one of the most effective antibiotics. Overall, only a few studies have been published on UTIs in Saudi Arabia. Moreover, not all regions have been represented, so the full scope of the issue is unknown. UTIs are still a major problem, and resistance has developed against commonly used antibiotics. Thus, large epidemiological studies are needed to battle the rapid emergence of antimicrobial resistance.

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“…Another study conducted in 2013 at Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, Saudi Arabia, showed nitrofurantoin had a resistance rate of 25% & 30% against E. coli and other Gram-negative bacteria, respectively [ 6 ]. Another recent study conducted in 2017 at Prince Mutaib bin Abdulaziz Hospital, Aljouf Region, Saudi Arabia, showed a resistance rate for fosfomycin and nitrofurantoin of 24.6% and 42.9%, respectively, against common Gram-negative uropathogens [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity Profile of Fosfomycin, Nitrofurantoin, and Co-trimoxazole Against Uropathogens Isolated From UTI Cases in a Secondary Care Center, KSA

Kazmi,

Fathima,

Khan

et al. 2024

Cureus

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Background Fosfomycin, nitrofurantoin, and co-trimoxazole are cheap and effective first-line oral antimicrobials in cases of uncomplicated cystitis in males and non-pregnant females. Fosfomycin and nitrofurantoin are called urinary antiseptics because these two drugs are primarily excreted in the kidney and concentrated in the urine without systemic effect. The present study was designed to evaluate the in vitro activities of fosfomycin, nitrofurantoin, and co-trimoxazole against uropathogens isolated at King Khalid Hospital Al-Majmaah, KSA. Methods The study was conducted at the King Khalid Hospital Al Majmaah, KSA, from September 1, 2021, until February 28, 2022. The patients' urine samples were inoculated on the Cystein Lactose Electrolytes Deficient (CLED) medium, and uropathogens were isolated. The organisms' identification and sensitivity testing against cotrimoxazole, fosfomycin, and nitrofurantoin was conducted using a Microscan automated analyzer, the MicroScan WalkAway Beckman Coulter, Sacramento, CA, USA. Results The study comprised non-repeat 137 patients who were either admitted to the hospital or treated as outpatients, yielding a total of 147 isolates. Nitrofurantoin showed a lower resistance rate, around 20% (n = 29), followed by fosfomycin at 23% (n = 34). The resistance rate of cotrimoxazole was 43% (n = 63). Overall, nitrofurantoin and fosfomycin showed relatively lower resistance against all isolates. Conclusions Being cheap and effective, we propose that fosfomycin and nitrofurantoin be used as first-line treatments in patients presenting with uncomplicated UTIs.

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Surveillance of antibiotic resistance among uropathogens in Aljouf region northern Saudi Arabia

Cited by 13 publications

References 29 publications

Antimicrobial Surveillance for Bacterial Uropathogens in Ha’il, Saudi Arabia: A Five-Year Multicenter Retrospective Study

Antimicrobial Surveillance for Bacterial Uropathogens in Ha’il, Saudi Arabia: A Five-Year Multicenter Retrospective Study

Urinary Tract Infections in the Kingdom of Saudi Arabia, a Review

Sensitivity Profile of Fosfomycin, Nitrofurantoin, and Co-trimoxazole Against Uropathogens Isolated From UTI Cases in a Secondary Care Center, KSA

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