The study of prevalence and antimicrobial susceptibility of bacterial isolated from urinary tract in outpatients admitted to Shohda hospital, Gonbad

Document Type : Original article

Authors

1 Young Researchers and Elite Club, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran

2 Young Researchers and Elite Club, Chalus Branch, Islamic Azad University, Chalus, Iran

3 Shohada Hospital in Gonbad-e Qabus, Golestan University of medical sciences, Gorgan, Iran

4 Dept. of medical microbiology, School of medicine, Iran University of medical sciences, Tehran, Iran

Abstract

Introduction:Urinary tract infection is the most common bacterial infection affecting human health. Early diagnosis, proper treatment and appropriate follow-up the patient can result in significant reduction in symptoms. Increase of drug resistance need for evaluation of antibiotic resistance patterns had revealed to improve empirical treatment. The purpose of this study is to identify common bacterial agents and evaluate their drug resistance pattern in Gonbad.
 
Methods: This cross-sectional study was conducted in outpatients admitted to Shohada hospital, Gonbad during a six-month period from February 2014 to July 2015. Identification of bacterial based on microbiological and biochemical tests was performed. Disk diffusion method performed on Mueller Hinton Agar was used to determine antibacterial activity of antibiotics in accordance with Clinical and Laboratory Standards Institute (2015) guidelines.
 
Results: Of 138 outpatients,the most common bacteria isolated from urine samples were including Escherichia coli 94 (%68.11), Klebsiella pneumoniae 16 (%11.59), Staphylococcus aureus 16 (%11.59) and Enterococus species 10 (%7.24) respectively. The most of isolated bacteria were susceptible to nitrofurantoin 65.14% and high resistance rates were observed for ampicillin, cotrimoxazole and cephalotin 56.70%, 43.76% and 44.82%, respectively.
 
Conclusion: Theidentified bacteria showed much lower rates of resistance to ciprofloxacin with prevalence rate of 47.27%. It is also recommended to lower ampicillin and co-trimoxazole use for initial treatment of urinary tract infections as high resistance.

Keywords


1.         Sussman M HJ. Topley and Wilson’s Microbiology and Microbial infections. 9th ed. Newcastle upon Tyne. Arnold; 1998. p. 601-21.
2.         Komala M, Kumar KS. Urinary tract infection: causes, symptoms, diagnosis and its Management. Indian Journal of Research in Pharmacy and Biotechnology 2013; 1(2):226.
3.         Martins A, Hunyadi A, Amaral L. Suppl 1: Mechanisms of Resistance in Bacteria: An Evolutionary Approach. The open microbiology journal 2013; 7: 53.
4.         Klemm P, Roos V, Ulett GC, Svanborg C, Schembri MA. Molecular characterization of the Escherichia coli asymptomatic bacteriuria strain 83972: the taming of a pathogen. Infection and immunity 2006; 74 (1):781-5.
5.         Wagenlehner F, Naber K. New drugs for Gram-positive uropathogens. International journal of antimicrobial agents 2004; 24:39-43.
6.         Mashouf RY, Babal havaeji H, Yousef J. Urinary tract infections: bacteriology and antibiotic resistance patterns. Indian pediatrics 2009; 46(7):617.
7.         Shanthi J, Kayathri S. Incidence, distribution and antibiogram of uropathogens isolated from patients with urinary tract infections. Adv Applied Sci Res 2012; 3:3410-4.
8.         Baran Ej FM. Bailey & Scott’s Diagnostic Microbiology. Toront: Mosby; 1999. p. 363-85.
9.         National Committee for clinical and laboratory standards. Performance standards for antimicrobial disk susceptibility tests: Approved standard: Wayne; 2003.
10.       National committee for clinical laboratory standards (NCCLS). In: Performance standards for Antimicobial susceptibility testing. Ninth information supplement, editor: Wayne 1999.
11.       CM K. urinary tract infection in females. Clin infect Dis 1994; 18:1-12.
12.       Gupta K, Sahm DF, Mayfield D, Stamm WE. Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in women: a nationwide analysis. Clinical infectious diseases 2001; 33(1):89-94.
13.       Al Sweih N, Jamal W, Rotimi V. Spectrum and antibiotic resistance of uropathogens isolated from hospital and community patients with urinary tract infections in two large hospitals in Kuwait. Medical Principles and Practice 2005; 14(6):401-7.
14.       Molazade AR SA, Gholami MS, Najafipoor S, Jafari S, Mobasheri F, et al. [Patterns of antibiotic-resistant gram-negative bacilli isolated from the urine of adult patients and outpatient medical diagnostic laboratories valie asr  hospital of Fasa city During the years 2011 to 2012]. Pars J med Sci 2014; 12(3):15-22.
15.       Molaabaszade H SB, Molazade M, Eslami K, Gheshlaghi N. [The pattern of antimicrobial susceptibility and resistance to E. coli strains isolated from urinary tract infections in the city of Tabriz]. Fasa Univ of Med Sci 2013; 2:149-54.
16.       Mirzarazi M, Rezatofighi SE, Pourmahdi M, Mohajeri MR. [Antibiotic resistance of isolated Gram negative bacteria from urinary tract infections (UTIs) in Isfahan]. Jundishapur Journal of Microbiology 2013; 6(8).
17.       Khosravi AD, Montazeri EA, Ghorbani A, Parhizgari N. [Bacterial urinary tract infection in renal transplant recipients and their antibiotic resistance pattern: A four-year study]. Iranian journal of microbiology 2014; 6(2):74.
18.       Alós JI, Serrano MG, Gómez‐Garcés JL, Perianes J. Antibiotic resistance of Escherichia coli from community‐acquired urinary tract infections in relation to demographic and clinical data. Clinical microbiology and infection2005; 11(3):199-203.
19.       Costa MMd, Drescher G, Maboni F, Weber S, Botton SdA, Vainstein MH, et al. Virulence factors and antimicrobial resistance of Escherichia coli isolated from urinary tract of swine in southern of Brazil. Brazilian Journal of Microbiology 2008; 39 (4):741-3.
20.       Abubakar E. Antimicrobial susceptibility pattern of pathogenic bacteria causing urinary tract infections at the Specialist Hospital, Yola, Adamawa state, Nigeria. J Clin Med Res 2009; 1(1):1-8.
21.       Kahlmeter G. The ECO• SENS Project: a prospective, multinational, multicentre epidemiological survey of the prevalence and antimicrobial susceptibility of urinary tract pathogens—interim report. Journal of Antimicrobial chemotherapy 2000; 46(suppl 1):15-22.
22.       Mansour A, Manijeh M, Zohreh P. [Study of bacteria isolated from urinary tract infections and determination of their susceptibility to antibiotics]. Jundishapur Journal of Microbiology 2009; (3 summer):118-23.