Mohammed SADEQ, Hevi GHAFOUR, Tayfur DEMİRAY, Mustafa ALTINDİŞ

Surveillance of urine cultures and evaluation gram negative uropathogens;five year data from Erbil

Objective: Urinary tract infections (UTIs) are most common infectious disease and a public health problem that imposes a large economic burden. Determining the distribution and resistance profiles of uropathogens in a region is important for planning empirical treatments, preventing antimicrobial drug resistance and establishing rational antibiotic use policies. The aim of this study is to gather surveillance data of urine cultures and determine the prevalence of uropathogens in urine samples of patients referred to outpatient clinics in Erbil region and to evaluate the antimicrobial susceptibility of the gram negative uropathogens. Methods: All urine cultures result of patients referred to Erbil hospitals in the last 5 years (2015-2020) are retrospectively examined in this study. Microorganisms are identified by standard bacterial methods and their susceptibilities are assessed by VITEK 2 (bioMérieux, Marcy l’Etoile, France) automated system. Results: The results of urine culture of 3380 suspected UTI cases are examined and out of 3097 positive cultures observed, a total of 1961 (63.3%) isolates are gram-negative and 1136 (36.7%) are gram-positive pathogens. Conclusion: The most common urinary pathogen determined in this study is Escherichia coli. The highest resistances of gram-negative urinary pathogens are against the ampicillin, trimethoprim/sulfamethoxazole and ceftriaxone. It is thought that the data obtained from this study will be useful in the planning of empirical treatment of urinary tract infections and in the development of rational antibiotic use policies.

Keywords:

Urine Culture, Urinary Tract Infections, Antimicrobial Resistance, Antimicrobial Resistance,

PDF

___

Köves B, Cai T, Veeratterapillay R, Pickard R, Seisen T, Lam TB, Yuan CY, Bruyere F, Wagenlehner F, Barto-letti R, Geerlings SE, Pilatz A, Pradere B, Hofmann F, Bonkat G, Wullt B. Benefits and Harms of Treatment of Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis by the European Association of Urology Urological Infection Guidelines Panel. Eur Urol. 2017;72(6):865-868. https://doi.org/10.1016/j.eururo.2017.07.014.
Anderson GG, Goller CC, Justice S, Hultgren SJ, Seed PC. Polysaccharide capsule and sialic acid-mediated regulation promote biofilm-like intracellular bacterial communities during cystitis. Infect Immun. 2010;78(3):963-975. https://doi.org/10.1128/IAI.00925-09
Beyer AK, Currea GCC, Holm A. Validity of microscopy for diagnosing urinary tract infection in general practice - a systematic review. Scand J Prim Health Care. 2019;37(3):373-379. https://doi.org/10.1080/02813432.2019.1639935
Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mecha-nisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269-284. https://doi.org/10.1038/nrmicro3432
Ganguly N, Wattal C, Chandy S, Arora S, Gupta U, and Kotwani A. Situation Analysis Antibiotic Use and Resistance in India. Public Health Foundation of India and Center for Disease Dynamics, Economics and Policy. 2011;209-212.
Scholes D, Hooton TM, Roberts PL, Stapleton AE, Gupta K, Stamm WE. Risk factors for recurrent urinary tract infection in young women. J Infect Dis. 2000;182(4):1177-82. https://doi.org/10.1086/315827.
Walsh T and Collyns T. The pathophysiology of urinary tract infections. Surgery (Oxford), 2017;35(6):293-298. https://doi.org/10.1016/J.MPSUR.2017.03.007
Oteo J, Pérez-Vázquez M, Campos J. Extended-spectrum [beta]-lactamase producing Escherichia coli: changing epidemiology and clinical impact. Curr Opin Infect Dis. 2010;23(4):320-6. https://doi.org/10.1097/qco.0b013e3283398dc1.
Martens E, Demain AL. The antibiotic resistance crisis, with a focus on the United States. J Antibiot. 2017 May;70(5):520-526. https://doi.org/10.1038/ja.2017.30.
Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012;15;366(11):1028-37. https://doi.org/10.1056/NEJMcp1104429.
Ahmed SS, Shariq A, Alsalloom AA, Babikir IH, Alhomoud BN. Uropathogens and their antimicrobial re-sistance patterns: Relationship with urinary tract infections. Int J Health Sci. 2019;13(2):48-55.
Aktaş O, Denktaş E. Five- Year Evaluation of the Urine Culture Results and Antimicrobial Susceptibility Profiles of Isolated E. coli Strains. Biomed J Sci & Tech Res. 2020; 24(2). https://doi.org/10.26717/BJSTR.2020.24.004029
Giwa FJ, Ige OT, Haruna DM, Yaqub Y, Lamido TZ, Usman SY. Extended-Spectrum beta-lactamase pro-duction and antimicrobial susceptibility pattern of uropathogens in a Tertiary Hospital in Northwestern Nigeria. Ann Trop Pathol 2018;9:11-6 https://doi.org/10.4103/atp.atp_39_17
Gupta N, Kundra S, Sharma A, Gautam V, Arora DR. Antimicrobial susceptibility of uropathogens in In-dia. J Infect Dis Antimicrob Agents. 2007;24:13-18.
Osman AA. Antibiotic Resistance of Bacteria isolated in Urinary Tract Infections in Erbil City. Zanco J of Pure and Applied Sci. 2019; 31(4):42-49. https://doi.org/10.21271/zjpas.31.4.5
Abujnah AA, Zorgani A, Sabri MA, El-Mohammady H, Khalek RA, Ghenghesh KS. Multidrug resistance and extended-spectrum β-lactamases genes among Escherichia coli from patients with urinary tract in-fections in Northwestern Libya. Libyan J Med. 2015;2;10:26412. https://doi.org/10.3402/ljm.v10.26412.
Ali FA, Merza EM and Aula TS. Antibiotic resistance among Escherichia coli isolated from different clinical samples in Erbil City. Int J of Research Studies in Sci, Eng and Tech. 2017;4(10):12-21.
Edlin RS, Shapiro DJ, Hersh AL, Copp HL. Antibiotic resistance patterns of outpatient pediatric urinary tract infections. J Urol. 2013;190(1):222-7. https://doi.org/10.1016/j.juro.2013.01.069.
Mohammed MA, Alnour TM, Shakurfo OM, Aburass MM. Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infection in Messalata Central Hospi-tal, Libya. Asian Pac J Trop Med. 2016;9(8):771-6. https://doi.org/10.1016/j.apjtm.2016.06.011.
Hertz FB, Schønning K, Rasmussen SC, Littauer P, Knudsen JD, Løbner-Olesen A, Frimodt-Møller N. Epi-demiological factors associated with ESBL- and non ESBL-producing E. coli causing urinary tract infection in general practice. Infect Dis (Lond). 2016;48(3):241-5. https://doi.org/10.3109/23744235.2015.1103895