Bacterial Urinary Tract Infections in North West of Iran: A Cross- Sectional Study

Background and Objective: Bacteria play a major role in urinary tract infections (UTIs); therefore, it is necessary to be aware of their regional prevalence and the causative pathogens for better prognosis and rapid treatment in clinical settings. This study aims to evaluate the prevalence of bacterial isolates involved in UTI samples and their antibiotics resistance pattern. Materials and Methods: In this cross-sectional study, bacterial infections from ۴۲۱۴ urine samples were analyzed from December ۲۰۱۶ to December ۲۰۱۸. After biochemical tests, disk diffusion susceptibility procedures were performed on all positive clinical cultures, according to CLSI guidelines. The obtained data were sorted and statistically analyzed by SPSS ۲۶. Results: Out of ۳۵۸۲ suspected UTIs samples, ۲۰۰۶ (۵۶%) were females and ۱۵۷۶ (۴۴%) males in the ۰-۹۹ years old age range and mainly consisting of middle-aged and elderly patients (۶۲.۲%). Escherichia coli (۵۳.۴۳%) and Staphylococcus epidermidis (۱۵.۹۹%) were the most frequent isolates. Among gram negative bacteria, nitrofurantoin and among gram- positive, vancomycin represented the lowest resistance rates at ۲۵.۲۷% and ۲۶.۷۴% respectively. Piperacillin showed the least efficacy with a resistance rate of ۷۶.۰۴%, followed by cefazolin with a ۷۴.۹۴% resistance rate.  In gram positive bacteria, vancomycin and gentamicin showed more promise with respective resistance rates of ۱۹.۳۴% and ۲۷.۳۴%. The highest resistance was associated with ampicillin (۶۸.۶۱%) and Trimethoprim/Sulfamethoxazole (۶۶.۰۶%). Conclusion: Alarming resistance rates were observed in ampicillin and piperacillin, which should be taken into account in therapy guidelines in this area. Prevalence of resistant strains can be avoided by developing appropriate healthcare policies and community awareness.

Keywords:

Antimicrobial Resistance , Bacteria , Hospital-acquired Infection , Urinary Tract Infection