Author/Authors :
Mostafavi, Nassereddin Infectious Disease and Tropical Medicine Research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Rostami, Soodabeh Nosocomial Infection research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Rezaee Nejad, Yasamin Infectious Disease and Tropical Medicine Research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Ataei, Behrooz Infectious Disease and Tropical Medicine Research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Mobasherizadeh, Sina Nosocomial Infection research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Cheraghi, Aazam Vice-chancelleries for Clinical Affairs - Isfahan University of Medical Sciences, Isfahan, Iran , Haghighipour, Somayeh Infectious Disease and Tropical Medicine Research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Nouri, Samereh Department of Microbiology - Clinical Laboratory of Alzahra Medical Center, Isfahan, Iran , Pourdad, Arezoo Alzahra Medical Center - Isfahan University of Medical Sciences, Isfahan, Iran , Ataabadi, Parisa Alzahra Medical Center - Isfahan University of Medical Sciences, Isfahan, Iran , Almasi, Nasser Dr. Shariati Hospital - Isfahan Social Security Organization, Isfahan, Iran , Heidary, Leila Dr. Shariati Hospital - Isfahan Social Security Organization, Isfahan, Iran , Naderi, Kourosh Dr. Shariati Hospital - Isfahan Social Security Organization, Isfahan, Iran , Korangbeheshti, Setareh Dr. Shariati Hospital - Isfahan Social Security Organization, Isfahan, Iran , Navabi, Shiva Dr. Gharazi Hospital - Isfahan Social Security Organization, Isfahan, Iran , Masssah, Laleh Dr. Gharazi Hospital - Isfahan Social Security Organization, Isfahan, Iran , Norouzi, Zohreh Dr. Gharazi Hospital - Isfahan Social Security Organization, Isfahan, Iran , Bakhtiyaritabar, Mehrnoush Dr. Gharazi Hospital - Isfahan Social Security Organization, Isfahan, Iran , Moayednia, Saeed Nosocomial Infection research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Mikhak, Mahin Dr. Shariati Hospital - Isfahan Social Security Organization, Isfahan, Iran , Rahmani, Majid Dr. Gharazi Hospital - Isfahan Social Security Organization, Isfahan, Iran , Hashemi, Mohammad Cardiovascular Department - Interventional Research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Etminani, Reza Vice-chancelleries for Clinical Affairs - Isfahan University of Medical Sciences, Isfahan, Iran , Ahmadi, Nasrin Vice-chancelleries for Clinical Affairs - Isfahan University of Medical Sciences, Isfahan, Iran , Kelishadi, Roya Child Growth and Development Research Center - Research Institute for Primordial Prevention of non-Communicable Disease - Isfahan University of Medical Sciences, Isfahan, Iran
Abstract :
Background: Antibiotic resistance against uro-pathogens is a worldwide health concern. The aim of this study was to determine the causative bacteria and antibiotic susceptibility patterns among hospitalized patients with community acquired urinary tract infection (UTI).
Methods: This cross-sectional study was performed in 2016-2018 in Isfahan, Iran. Urine samples were examined for strain identification and antimicrobial resistance pattern using standard tests. Stratification was done based on gender and age (<20 and >20 years) groups. Chi-square and Fisher exact tests were applied to assess differences in etiology and susceptibility rates between groups.
Results: Among 1180 patients, Escherichia coli was the commonest pathogen (68.1%) followed by Enterococcus spp. (8.8%) and Klebsiella pneumonia (8.0 %). Non-E. coli pathogens were more frequent among males (41.8% versus 24.8% in females, P<0.01) and in those aged under 20 years (61.0% versus 22.2% in older than 20 years, P<0.01). Isolated bacteria revealed high susceptibility to imipenem (94.9%), meropenem (92.2%), and amikacin (91.9%); moderate sensitivity to gentamicin (64.4%), cefepime (52.6%) and ceftazidime (47.2%); and low susceptibility to ceftriaxone (41.8%), cefotaxime (40.0%), ciprofloxacin (38.6%) and trimethoprim-sulfamethoxazol (31.3%). The sensitivity of isolates to ceftriaxone, ceftazidime, cefepime, imipenem, meropenem, amikacin and ciprofloxacin was significantly higher in females. Compared to the older age group, uro-pathogens were more susceptible to ciprofloxacin, ceftazidime and gentamicin in patients aged under 20 years.
Conclusion: We found that imipenem, meropenem and amikacin were good choices for empiric therapy of complicated or severe hospitalized patients with community acquired UTI; and gentamicin, cefepime and ceftazidime were acceptable as initial choices in non-severe infections in the area.
