Document Type : Original Research

Authors

1 Dept. of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 Thrombosis Hemostasis Research Center, Imam Hospitals Complex, Tehran University of Medical Sciences, Tehran, Iran

10.7508/ijp.2015.01.008

Abstract

Background and Objectives: Urinary tract infections (UTI) are one of the most common infectious diseases with different microbial agent and antimicrobial resistant pattern in hospitalized patients and outpatients. In order to assess the adequacy of therapy, knowledge of prevalence and resistance pattern of the bacteria is necessary. The main aim of this study was to evaluate the prevalence and the antimicrobial resistance pattern of main bacterial responsible for UTI in order to establish an appropriate empirical therapy. Methods: All urine samples were referred to Imam Hospital Laboratory, Tehran, Iran during 2011-2012, urine culture isolated and bacteria were identified and the profile of antibiotic susceptibility was characterized. Result: From 1851 urine cultures, UTI was more frequent in woman (68%) E. coli was as usual the most common pathogen implicated in UTI. Most susceptibility was to imipenem (98.9%). nitroforantoin (96%) and amikacin (94.1%) and increased resistance to penicillin (66.6%), nalidixic acid (62.1%) ampicilin (60.1%) and cotrimoxazole 54.3%. Discussion: The most common isolated pathogen was E. coli. According to antibiogram susceptibility, the recommended antimicrobial drugs are nitroforantoin and imipenem. nalidixic acid and cotrimoxazole are not recommended because drug resistance is high.  

Keywords

  1. Linhares et al.frequency and antimicrobial resistance pattern of bacterial implicated in community urineary tract infections, a ten year surveillance study 2000-2009. BMC Infections Disease J 2013 ;13(19) .
  2.  Saderi H, Owlia P, Jalali Nadushan MR, Zaeri F, Zandieh E. A tree-year study of demographic characteristics of patients with urineary tract infection, microbial etiology, and susceptibility of isolated bacteria to antibiotics in shaheed Mostafa Khomeini hospital. Iranian J Pathol 2006; 1(3):99-104.
  3. Orrett FA, Davis GK. A comparison of antimicrobial susceptibility profile of urineary pathogens for the years, 1999 and 2003. West Indian Med J 2006; 55(2):95-9.
  4. Hasan AS, Nair D, Kaur J, Baweja G, Deb M, Aggarwal P. Resistance patterns of urineary isolates in a tertiary Indian hospital. J Ayub Med Coll Abbottabad 2007; 19(1):39-41.
  5. Walter E. Stamm.Urineary tract infection. Kasper D, Braunwald E, Fauci A, Hauser S, Longo D, Jameson J.L. In: Harrison’s priciples of internal medicine. 16th ed. New York: McGraw-Hill; 2005.
  6. Keah SH, Wee EC, Chng KS , Keah KC. Antimicrobial susceptibility of community-acquired uropathogens in general practice. Malaisian Family Phisician 2007; 2(2):64-9.
  7. De Francesco MA , Ravizzola G , Peroni L , Negrini R , Manca N .Urineary tract infections in Brescia,Italy:Etiology of uropathogens and antimicrobial resistance of common uropathogens. Med Sci Monit 2007;13(6):BR136-144.
  8. Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urineary tract infection in JNMC Hospital Aligarh, India. Ann Clin Microbiol Antimicrob 2007; 6:4.
  9. Kamat US, Ferreira AMA, Savio R, Motghare DD. Antimicrobial resistance among nosocomial isolates in a teaching hospital in Goa. Indian J Community Med 2007; 33(2):89-92
  10. Peterson J, Kaul S, Khashab M, Fisher A, Kahn JB. Identification and pretherapy susceptibility of pathogens in patients with complicated urineary tract infection or acute pyelonephritis enrolled in a clinical study in the United States from November 2004 through April 2006. Clin Ther 2007; 29(10):2215-21.
  11. De Backer D, Christiaens T, Heytens S, De Sutter A, Stobberingh EE, Verschraegen G. Evolution of bacterial susceptibility pattern of Escherichia coli in uncomplicated urineary tract infection in a country with high antibiotic consumption: a comparison of two surveys with a 10 years interval. J Antimicrob Chemother 2008; 62:364-8.
  12. Randrianirina F, Soares JL, Carod JF , Ratsima E, Thonnier V, Combe P, et al. Antimicrobial resistance among uropathogens that cause community-acquired urineary tract infections in Antananarivo. Madagascar.J Antimicrob Chemother 2007;59:309-12.
  13. Grude N.Tveten Y, Kristiansen BE.Urineary tract infection in Norway, Bacterial etiology and susceptibility. A retrospective study of clinical isolates. Clinic Microbial infect 2001 7:543-7.
  14. Zhanel GG, Hisanaga TL , Laing NM, DeCorby MR, Nichol KA, Palatnick LP, et al. Antibiotic resistance in outpatiant urineary isolates:final results from the North American University Infection Collaborative Alliance(NAUTICA).Int J Antimicrob Agents 2005;26:380-8.
  15. Pires MC, Frota Kde S, Martins Junior Pde O, Correia AF, Cortez-Escalante JJ, Silveria CA. Prevalence and bacterial susceptibility of community acquired urineary tract infection in university hospital of Brasilia, 2001 to 2005. Rev Soc Bras Med Trop. 2007;40(6):643-7.
  16. Leblebicioglu H, Esen S; Turkish Nosocomial Urineary Tract Infection Study Group. Hospital-acquired urinary tract infection in Turkey: a nationwide multicenter point prevalence study. J Hosp Infect 2003; 53:207-10.
  17. Dias Neto JA, Magalhaes da Silva LD, Pereira Martins AC, Tiraboschi RB, Alonso Domingo AL, Suaid HJ, et al. Prevalence and bacterial susceptibility of hospital acquired urinary tract infection. Acta Cirurgica Brasileira 2003;18(supl.5):36-8.
  18. Jose Anastacio Dias Neto JA, Martins AC, Magalhaes da Silva LD, Tiraboschi RB, Alonso Domingos AL, Cologna AJ, et al. Community acquired urineary tract infection: etiology and bacterial susceptibility. Acta Cirurgica Brasileira 2003; 18(supl. 5):33-6.
  19. Andrade SS, Sader HS, Jones RN, Pereira AS, Pignatari AC, Gales AC. Increased resistance to first-line agents among bacterial pathogens isolated from urineary tract infections in Latin America:time for local guidelines! Mem Inst Oswaldo Cruz,Rio de janeiro 2006;101(7):741-8.
  20. Colodner R, Keness Y, Chazan B, Raz R. Antimicrobial susceptibility of community-acquired uropathogens in northern USA. Intern J Antimicrob Agents 2001; 18(2):189-92.