Author/Authors :
Fallah, Fatemeh Dept. of Microbiology - School of Medicine - Shahid Beheshti University of Medical Sciences, Tehran , Parhiz, Soha Dept. of Microbiology - School of Medicine - Shahid Beheshti University of Medical Sciences, Tehran , Azimi, Leila Pediatric Infection Research Center - Research Institute for Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Rashidan, Marjan School of medicine - Shahroud University of Medical Sciences
Abstract :
Background: Urinary Tract Infections (UTIs) remain the common
infections diagnosed in outpatients as well as hospitalized patients.
Multi-Drug Resistance (MDR) and Extensively-Drug Resistance (XDR)
in the bacteria is an alarming problem in the world. Thus, the present
study was conducted to detect the etiologic agents associated with
Community-Acquired Urinary Tract Infections (CA-UTIs) and
investigate the antibiotic susceptibility patterns.
Methods: This study was conducted on the outpatients referred to
Labbafinejad Hospital Clinic, Tehran, Iran from September 2014 to
March 2015. The bacterial pathogenic diversity was identified by
standard laboratory methods. The antimicrobial resistance rates were
determined by Kirby-Bauer disc diffusion method.
Results: A total of 303 patients were enrolled in this study, among
which 204 (67.3%) of them were female and 99 (32.5%) of them were
male. Escherichia coli was the dominant species (69%), followed by
Enterococcus faecalis (12.8%), and Klebsiella pneumoniae (4.6%).
High resistance rate was observed to nalidixic acid (73.8%),
trimethoprim/Sulfamethoxazole (54.3%), ciprofloxacin (54.3%) in E.
coli, and tetracycline (89.7%) in E. faecalis strains as well as high
susceptibility rate to meropenem (96.6%), imipenem (95.2%), amikacin
(90.4%), cefoxtin (87.6%), and nitrofurantoin (82.8%) in E. coli, and
nitrofurantoin (100%) in E. faecalis strains.In addition, 43.5% of the
strains were found to be Multi-Drug-Resistant (MDR).
Conclusions: The results of this study showed that, E. coli was the
predominant uropathogen of CA-UTIs in this geographical area. It was
also found that, the empirical treatment of urinary tract infections may
be difficult due to high resistance to commonly used antibiotics.
Continuous monitoring of MDR organisms and drug resistance
patterns is needed to prevent treatment failure and reduce selective
pressure. These findings suggest the use of nitrofurantoin, cefoxitin,
and amikacin in this area of the country.
