Alamri A, Hassan B, Hamid ME. Susceptibility of hospital-acquired uropathogens to first-line antimicrobial agents at a tertiary health-care hospital, Saudi Arabia.
Urol Ann 2021;
13:166-170. [PMID:
34194144 PMCID:
PMC8210707 DOI:
10.4103/ua.ua_109_20]
[Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
Context
Management of urinary tract infections (UTIs) is caused by antibiotic resistance uropathogens.
Aim
This study aimed to determine the important uropathogens and their resistance to first-line urinary tract antimicrobial agents.
Settings and Design
The region of Aseer, Southern Saudi Arabia, between 2013 and 2016.
Materials and Methods
A total of 1506 isolates were recovered from the urine samples of patients that were identified and tested against nine first-line UTI antimicrobial agents. Laboratory analysis was done as per the standard methods. Confirmation of bacterial identity and antimicrobial susceptibility assay was achieved by the VITEK 2 automated system.
Statistical Analysis Used
Statistical Package for the Social Sciences software version 21.0 was used for the statistical analysis.
Results
The dominant uropathogens were Escherichia coli (E. coli) 507 (33.7%); Klebsiella pneumoniae (K. pneumoniae), 229 (15.21%); Pseudomonas aeruginosa, 153 (10.2%); Acinetobacter baumannii, 80 (5.3%); Enterococcus faecalis, 71 (4.7%); and Proteus mirabilis, 61 (4.1%). Of all culture-positive uropathogens, 51.5% were resistant to the 39 agents, whereas 48.5% were sensitive (P = 0.7969). Regarding the susceptibility to the first-line agent, the most effective against the dominant (in vitro) agents against E. coli were fosfomycin and nitrofurantoin (93.5%) and (85.4%), respectively. Whereas those worked well against K. pneumoniae were cefoxitin (57.1).
Conclusions
The present study recommends the use of fosfomycin, cefoxitin, nitrofurantoin, and amoxicillin/clavulanate as the first choice UTIs treatment given their relatively high in vitro activity against major uropathogens. Knowledge of the bacterial species and their antimicrobial sensitivity patterns are always necessary to serve as a base for selecting the empirical treatment of UTIs as resistance rates vary geographically and with time.
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