Antibiotics Resistance Profile of Uropathogens Isolated from Al Buraimi Hospital, Sultanate of Oman

BACKGROUND: Urinary tract infections (UTIs) is a worldwide problem of all age groups and gender. Emerging resistance to antibiotics making difficult in the choice of treatment and management of UTI cases. This study sought to determine the gender wise prevalence of common uropathogens from UTI patients and the resistance profile of uropathogens against commonly used antibiotics. METHOD: This cross sectional study was conducted in Al Buraimi Hospital, Sultanate of Oman. The data of UTI patients visited hospital was analyzed for the isolation of uropathogens from positive urine culture and antimicrobial sensitivity test was performed by disc diffusion method. Descriptive statistics was used to analyze the data using SPSS 21.0 and Microsoft Excel. RESULT: Total 4,480 urine samples were analyzed for isolation of uropathogens and significant bacteriuria were found in total 846 (19%) samples. Overall 728 (86%) Gram-negative and 118 (14%) Gram positive uropathogens were isolated from total (846) positive urine samples and the highest prevalence of isolates was observed in females 542(74%) than males 186(26%). E.coli was found the highest prevalent (50.3%) uropathogens followed by Klebsiella species (13.9%), Pseudomonas (6.3%), A.baumannii (4%), E.Cloacae (2.2%), Proteus species (1.4%), Citrobacter species (1.2%), M. morgani (0.3%) and Serratia species (0.1%). The highest (34.3%) antibiotic resistance was noticed in E.coli against Nalidixic Acid, however, susceptiblity was found against Ceftriaxone, Ceftazidime, Ciprofloxacin and Nitrofurantoin among female and males. CONCLUSION: Overall, β- lactam antibiotics, Cephalosporins, Fluroquiolones, Macrobids would be the first line of drugs and the most effective for the empirical treatment of Gram-negative and Gram-positive uropathogens; however Aminoglycosides, Carbapenems and Polymyxin could be used for the treatment of UTI infections as the second choice.

[1]  Madhuri Ashok Lawhale,et al.  Recent pattern of drug sensitivity of most commonly isolated uropathogens from Central India , 2017 .

[2]  H. Žemličková,et al.  The susceptibility to fosfomycin of Gram-negative bacteria isolates from urinary tract infection in the Czech Republic: data from a unicentric study , 2017, BMC Urology.

[3]  A. Gad,et al.  The Occurrence of Multidrug Resistant E. Coli which Produce ESBL and Cause Urinary Tract Infections , 2017 .

[4]  C. McBride,et al.  Paediatric urinary tract infections: Diagnosis and treatment. , 2016, Australian family physician.

[5]  S. W. Sharef,et al.  Incidence of antibiotics resistance among uropathogens in Omani children presenting with a single episode of urinary tract infection. , 2015, Journal of infection and public health.

[6]  M. Khurshid,et al.  Characteristics and Antibiotic Resistance of Urinary Tract Pathogens Isolated From Punjab, Pakistan , 2015, Jundishapur journal of microbiology.

[7]  G. Dbaibo,et al.  Epidemiology and characteristics of urinary tract infections in children and adolescents , 2015, Front. Cell. Infect. Microbiol..

[8]  M. Islam,et al.  Extended-spectrum-beta-lactamase producing uropathogenic Escherichia coli infection in Dhaka, Bangladesh , 2015 .

[9]  Farhan Essa Abdullah,et al.  Antibiotic resistance pattern of Pseudomonas aeruginosa isolated from urine samples of Urinary Tract Infections patients in Karachi, Pakistan , 2015, Pakistan journal of medical sciences.

[10]  S. Poongodi,et al.  Recent Sensitivity Pattern of Escherichia Coli in Urinary Tract Infection , 2014 .

[11]  J. Schrenzel,et al.  Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia survey from the fungal infection network of Sw , 2014, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[12]  N. Bhadelia,et al.  Management of urinary tract infections from multidrug-resistant organisms. , 2014, Infectious disease clinics of North America.

[13]  Betsy Foxman,et al.  Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. , 2014, Infectious disease clinics of North America.

[14]  N. Singla,et al.  Determination of Extended-Spectrum β-Lactamases and AmpC Production in Uropathogenic Isolates of Escherichia coli and Susceptibility to Fosfomycin , 2013, Journal of laboratory physicians.

[15]  W. Ko,et al.  Emerging resistance problems and future perspectives in pharmacotherapy for complicated urinary tract infections , 2013, Expert opinion on pharmacotherapy.

[16]  Brendan F Gilmore,et al.  Clinical relevance of the ESKAPE pathogens , 2013, Expert review of anti-infective therapy.

[17]  M. Levison,et al.  Treatment of Complicated Urinary Tract Infections With an Emphasis on Drug-Resistant Gram-Negative Uropathogens , 2013, Current Infectious Disease Reports.

[18]  Muktikesh Dash,et al.  Antimicrobial resistance in pathogens causing urinary tract infections in a rural community of Odisha, India , 2013, Journal of family & community medicine.

[19]  S. Hultgren,et al.  Molecular blueprint of uropathogenic Escherichia coli virulence provides clues toward the development of anti-virulence therapeutics , 2012, Virulence.

[20]  S. Hultgren,et al.  Host-pathogen checkpoints and population bottlenecks in persistent and intracellular uropathogenic Escherichia coli bladder infection. , 2012, FEMS microbiology reviews.

[21]  I. Shaifali,et al.  Antibiotic Susceptibility Patterns of Urinary Pathogens in Female Outpatients , 2012, North American journal of medical sciences.

[22]  S. Hultgren,et al.  Immune Activation and Suppression by Group B Streptococcus in a Murine Model of Urinary Tract Infection , 2011, Infection and Immunity.

[23]  J. Sobel,et al.  Candida urinary tract infection: pathogenesis. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[24]  R. Omoregie,et al.  Urinary tract infection in a rural community of Nigeria , 2011, North American journal of medical sciences.

[25]  Betsy Foxman,et al.  The epidemiology of urinary tract infection , 2010, Nature Reviews Urology.

[26]  H. Mobley,et al.  Host–pathogen interactions in urinary tract infection , 2010, Nature Reviews Urology.

[27]  Atul Kothari,et al.  Antibiotic resistance in pathogens causing community-acquired urinary tract infections in India: a multicenter study. , 2008, Journal of infection in developing countries.

[28]  L. van Dijk,et al.  Antibiotics for respiratory, ear and urinary tract disorders and consistency among GPs. , 2008, The Journal of antimicrobial chemotherapy.

[29]  M. Malhotra,et al.  Enterococcal infections & antimicrobial resistance. , 2008, The Indian journal of medical research.

[30]  H. Mobley,et al.  Complicated Catheter-Associated Urinary Tract Infections Due to Escherichia coli and Proteus mirabilis , 2008, Clinical Microbiology Reviews.

[31]  J. Garau,et al.  Other antimicrobials of interest in the era of extended-spectrum beta-lactamases: fosfomycin, nitrofurantoin and tigecycline. , 2008, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[32]  S. Keah,et al.  Antimicrobial susceptibility of community-acquired uropathogens in general practice. , 2007, Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia.

[33]  A. Hasan,et al.  Resistance patterns of urinary isolates in a tertiary Indian hospital. , 2007, Journal of Ayub Medical College, Abbottabad : JAMC.

[34]  David L Paterson Resistance in gram-negative bacteria: enterobacteriaceae. , 2006, The American journal of medicine.

[35]  N. Shrestha,et al.  Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal. , 2006, Singapore medical journal.

[36]  Patrice Courvalin,et al.  Vancomycin resistance in gram-positive cocci. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[37]  A. Ronald The etiology of urinary tract infection: traditional and emerging pathogens. , 2002, The American journal of medicine.

[38]  M. Finland,et al.  Asymptomatic infections of the urinary tract. , 2002, The Journal of urology.

[39]  T. Hooton,et al.  Increasing Antimicrobial Resistance and the Management of Uncomplicated Community-Acquired Urinary Tract Infections , 2001, Annals of Internal Medicine.

[40]  S. T. Cowan,et al.  Cowan and Steel's manual for the identification of medical bacteria , 1993 .

[41]  R. W. Ross,et al.  Rapid, Modified Kirby-Bauer Susceptibility Test with Single, High-Concentration Antimicrobial Disks , 1973, Antimicrobial Agents and Chemotherapy.

[42]  Mabeck Ce Uncomplicated urinary tract infection in women. , 1971 .