Spectrum and Antibiotic Resistance of Uropathogens Isolated from Hospital and Community Patients with Urinary Tract Infections in Two Large Hospitals in Kuwait

Objectives: To determine the spectrum of microbial etiology and antibiotic resistance pattern of the uropathogens that cause urinary tract infections in 2 large teaching hospitals in Kuwait over a period of 1 year. Materials and Methods: The Vitek identification card system was used to identify the uropathogens. Susceptibility of the isolates against 18 antibiotics was performed by the microbroth dilution method using the Vitek automated system. In addition, gram-positive bacteria were tested in parallel by the disk diffusion technique. Results: The six overall most common isolates were: Escherichia coli, accounting for 47% of isolates in both hospitals, followed by Candida spp. (10.8%), Klebsiella pneumoniae (9.6%), Streptococcus agalactiae (GBS; 9.5%), Enterococcusfaecalis (4.2%) and Pseudomonas aeruginosa (4.1%). Amikacin provided the widest coverage amongst all the antibiotics tested followed by ciprofloxacin, gentamicin and piperacillin-tazobactam. For the gram-negatives, high resistance (26–63%) to the β-lactam antibiotics was noted, especially to ampicillin, amoxicillin-clavulanic acid, cephalothin and cefuroxime. Resistance to trimethoprim-sulfamethoxazole was also high. None of the enterococci was resistant to the glycopeptides, but 38–60% of the Staphylococcus haemolyticus were resistant to vancomycin or teicoplanin. Conclusion: These data show the high level of antimicrobial resistance amongst the uropathogens causing urinary tract infection in the two hospitals studied.