Antimicrobial Resistance in Hospitalized Patients with Community Acquired Urinary Tract Infection in Isfahan, Iran

被引:6
作者
Mostafavi, Sayed Nassereddin [1 ,2 ]
Rostami, Soodabeh [3 ]
Nejad, Yasamin Rezaee [1 ]
Ataei, Behrooz [1 ]
Mobasherizadeh, Sina [3 ]
Cheraghi, Aazam [4 ]
Haghighipour, Somayeh [1 ]
Nouri, Samereh [5 ]
Pourdad, Arezoo [6 ]
Ataabadi, Parisa [6 ]
Almasi, Nasser [7 ]
Heidary, Leila [7 ]
Naderi, Kourosh [7 ]
Korangbeheshti, Setareh [7 ]
Navabi, Shiva [8 ]
Masssah, Laleh [8 ]
Norouzi, Zohreh [8 ]
Bakhtiyaritabar, Mehrnoush [8 ]
Moayednia, Saeed [5 ]
Shokri, Dariush [3 ]
Mikhak, Mahin [7 ]
Rahmani, Majid [8 ]
Hashemi, Mohammad [9 ]
Etminani, Reza [4 ]
Ahmadi, Nasrin [4 ]
Kelishadi, Roya [2 ]
机构
[1] Isfahan Univ Med Sci, Infect Dis & Trop Med Res Ctr, Esfahan, Iran
[2] Isfahan Univ Med Sci, Res Inst Primordial Prevent Noncommunicable Dis, Child Growth & Dev Res Ctr, Esfahan, Iran
[3] Isfahan Univ Med Sci, Nosocomial Infect Res Ctr, Esfahan, Iran
[4] Isfahan Univ Med Sci, Vice Chancelleries Clin Affairs, Esfahan, Iran
[5] Alzahra Med Ctr, Dept Microbiol, Clin Lab, Esfahan, Iran
[6] Isfahan Univ Med Sci, Alzahra Med Ctr, Esfahan, Iran
[7] Dr Shariati Hosp, Isfahan Social Secur Org, Esfahan, Iran
[8] Dr Gharazi Hosp, Isfahan Social Secur Org, Esfahan, Iran
[9] Isfahan Univ Med Sci, Intervent Res Ctr, Cardiovasc Dept, Esfahan, Iran
关键词
Antimicrobial susceptibility; Community acquired; Hospitalized; Infection; Iran; Urinary tract; UROPATHOGENS; PATHOGENS; PATTERNS; CHILDREN;
D O I
10.34172/aim.2021.29
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:187 / 192
页数:6
相关论文
共 21 条
[11]   Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis [J].
Mortazavi-Tabatabaei, Seyed Abdol Reza ;
Ghaderkhani, Jalal ;
Nazari, Ali ;
Sayehmiri, Kourosh ;
Sayehmiri, Fatemeh ;
Pakzad, Iraj .
INTERNATIONAL JOURNAL OF PREVENTIVE MEDICINE, 2019, 10
[12]   Methodology and early results of the first surveillance program on prevention and control of antimicrobial resistance in Isfahan, Iran: The IAS-I study [J].
Mostafavi, Sayed Nasser ;
Rostami, Soodabeh ;
Ataei, Behrooz ;
Mobasherizadeh, Sina ;
Cheraghi, Azam ;
Haghighipour, Somayeh ;
Nouri, Samereh ;
Pourdad, Arezoo ;
Ataabadi, Parisa ;
Almasi, Naser ;
Heidary, Leila ;
Naderi, Kourosh ;
Korangbeheshti, Setareh ;
Navabi, Shiva ;
Masssah, Laleh ;
Norouzi, Zohreh ;
Bakhtiyaritabar, Mehrnoush ;
Moayednia, Saeed ;
Shokri, Dariush ;
Mikhak, Mahin ;
Rahmani, Majid ;
Hashemi, Mohammad ;
Etminani, Reza ;
Ahmadi, Nasrin ;
Akhlaghi, Mahboubeh ;
Kelishadi, Roya .
INTERNATIONAL JOURNAL OF PREVENTIVE MEDICINE, 2020, 11 (01) :137
[13]  
Nozarian Zohreh, 2015, Iran J Pathol, V10, P54
[14]   The impact of therapeutic delay time on acute scintigraphic lesion and ultimate scar formation in children with first febrile UTI [J].
Oh, Mi Mi ;
Kim, Jin Wook ;
Park, Min Gu ;
Kim, Je Jong ;
Yoo, Kee Hwan ;
Moon, Du Geon .
EUROPEAN JOURNAL OF PEDIATRICS, 2012, 171 (03) :565-570
[15]   Epidemiology of urological infections: a global burden [J].
Ozturk, Recep ;
Murt, Ahmet .
WORLD JOURNAL OF UROLOGY, 2020, 38 (11) :2669-2679
[16]   Etiology and sensitivity of uropathogens in outpatients and inpatients with urinary tract infection: Implications on empiric therapy [J].
Pai, Vidya ;
Nair, Bhaskaran .
ANNALS OF TROPICAL MEDICINE AND PUBLIC HEALTH, 2012, 5 (03) :181-184
[17]   State of the Globe: Rising Antimicrobial Resistance of Pathogens in Urinary Tract Infection [J].
Paul, Rudrajit .
JOURNAL OF GLOBAL INFECTIOUS DISEASES, 2018, 10 (03) :117-+
[18]   A Comparison of Inpatient Versus Outpatient Resistance Patterns of Pediatric Urinary Tract Infection [J].
Saperston, Kara N. ;
Shapiro, Daniel J. ;
Hersh, Adam L. ;
Copp, Hillary L. .
JOURNAL OF UROLOGY, 2014, 191 (05) :1608-1613
[19]   A systematic review: The current status of carbapenem resistance in East Africa [J].
Ssekatawa K. ;
Byarugaba D.K. ;
Wampande E. ;
Ejobi F. .
BMC Research Notes, 11 (1)
[20]   Determinants of Quinolone versus Trimethoprim-Sulfamethoxazole Use for Outpatient Urinary Tract Infection [J].
Stuck, Anna K. ;
Taeuber, Martin G. ;
Schabel, Maria ;
Lehmann, Thomas ;
Suter, Herbert ;
Muehlemann, Kathrin .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2012, 56 (03) :1359-1363