Frequency and Antibiotic Susceptibility Pattern of Uro-Pathogens Isolated from Community and Hospital-Acquired Infections in Saudi Arabia – A Prospective Case Study

Abstract

Objective: Urinary tract infection (UTI) remains a worldwide therapeutic problem, not only as a nosocomial disease but also as a community-acquired infection. Antibiotic resistance of urinary tract pathogens has increased worldwide. Infectious Diseases Society of America (IDSA) recently recommended that each hospital should determine the locally establish mechanisms to resistance rates among uropathogens. The aim of this study was to determine the frequency of the bacterial agents that cause urinary tract infection both in outpatients as well as in hospitalized patients and to assess the antimicrobial sensitivity pattern against various types of antimicrobial agents used for treating urinary tract infections. Materials and Methods: We carried out a prospective study of urine culture and antibiotic sensitivity testing from symptomatic outpatients and inpatients. Results: A total 150 cases were positive for significant bacteria, out of which 83 (55.4%) were from out patients and 67 (44.6%) were from hospitalized patients. The majority of the bacteria were isolated from female (78.7%) while the remaining was from male (21.3%). In the present study Escherichia coli was the predominant pathogen for UTI in both the groups. Klebsiella sps was the second common organism in hospital acquired infection followed by Pseudomonas. sps. Analysis of the frequency of bacterial isolates according to the age of the patients revealed that Escherichia coli and Klebsiella infections were more prevalent in the age groups (>20-49 years) and Pseudomonas infections were more prevalent in children and the elderly (<20 years and >50 years, respectively) and Salmonella typhi were isolated from elderly (>60 years age) patient from community–acquired infection. The mean susceptibility was high for Imipenem (98.8%), Amikacin (53.2%), Gentamicin (52.3%) and Ciprofloxacin (50.5%) but low for Ampicillin (34.2%), Norfloxacin (40.4%), Nitrofurantoin (44.5%), and Co-trimoxazole (46.7%). High prevalence of Multi-drug resistance (MDR) isolates were recovered (53%) which showed 3 or more antibiotics resistance. Conclusion: Current knowledge of the antibiotic resistance patterns of uro-pathogens in specific geographical locations is an important factor for choosing an appropriate empirical antimicrobial treatment rather than on universal guidelines.