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Antimicrobial Resistance in Hospitalized Patients With Community Acquired Urinary Tract Infection in Isfahan, Iran Publisher Pubmed



Mostafavi SN1, 2 ; Rostami S3 ; Nejad YR1 ; Ataei B1 ; Mobasherizadeh S3 ; Cheraghi A4 ; Haghighipour S1 ; Nouri S5 ; Pourdad A6 ; Ataabadi P6 ; Almasi N7 ; Heidary L7 ; Naderi K7 ; Korangbeheshti S7 Show All Authors
Authors
  1. Mostafavi SN1, 2
  2. Rostami S3
  3. Nejad YR1
  4. Ataei B1
  5. Mobasherizadeh S3
  6. Cheraghi A4
  7. Haghighipour S1
  8. Nouri S5
  9. Pourdad A6
  10. Ataabadi P6
  11. Almasi N7
  12. Heidary L7
  13. Naderi K7
  14. Korangbeheshti S7
  15. Navabi S8
  16. Masssah L8
  17. Norouzi Z8
  18. Bakhtiyaritabar M8
  19. Moayednia S5
  20. Shokri D3
  21. Mikhak M7
  22. Rahmani M8
  23. Hashemi M9
  24. Etminani R4
  25. Ahmadi N4
  26. Kelishadi R2
Show Affiliations
Authors Affiliations
  1. 1. Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Child Growth and Development Research Center, Research Institute for Primordial Prevention of non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Nosocomial Infection research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Vice-chancelleries for Clinical Affairs, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Microbiology, Clinical Laboratory of Alzahra Medical Center, Isfahan, Iran
  6. 6. Alzahra Medical Center, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Dr. Shariati Hospital, Isfahan Social Security Organization, Isfahan, Iran
  8. 8. Dr. Gharazi Hospital, Isfahan Social Security Organization, Isfahan, Iran
  9. 9. Cardiovascular Department, Interventional Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Archives of Iranian Medicine Published:2021


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. © 2021 The Author(s).
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