Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.5281/zenodo.4899616
Iberoamerican Journal of Medicine
Original article

Prevalence and Antibiotics Susceptibility Pattern of Urine Bacterial Isolates from Tripoli Medical Center (TMC), Tripoli, Libya

Prevalencia y patrón de susceptibilidad a los antibióticos de los aislados bacterianos en orina del centro médico de Trípoli (TMC), Trípoli, Libia

Abir Ben Ashur, Hamida El Magrahi, Asma Elkammoshi, Hiba Alsharif

Downloads: 19
Views: 2667

Abstract

Introduction: Urinary tract infections (UTI) are one of the most common human bacterial infections encountered by physicians. The risk of resistant microbes is emerging as a result of the overuse of antibiotics treatments. The presence of pathogens with increased resistance to antimicrobial agents makes UTIs difficult to treat. This study was aimed at determining the prevalence of the pathogens that cause UTIs, as well as the antibiotic susceptibility of these isolates.
Materials and methods: This prospective study was conducted from February 2020 to April 2020; a total number of 200 urine samples were collected from patients who daily attended TMC Libya. Bacterial pathogens were determined by bacteriological culture methods and Antimicrobial susceptibility testing was done by using the disc diffusion method.
Results: Out of 200 samples, 110 cases had a positive culture. The dominant bacterial pathogens were Gram-negative that being with Escherichia coli (49, 55.68%), followed by Klebsiella pneumonia (18, 20.46%), Pseudomona aeruginosa (9, 10.23%), Proteus mirabilis (8, 9.09%), Enterobacter aerogenes (2, 2.27%), Citrobacter freundii (2, 2.27%). Gram-positive bacteria were Staphylococcus aureus 20 (90.91%) followed by S. saprophyticus (2, 9.01%) of the isolate’s strains. The isolated uropathogen showed increased levels of resistance to antibiotics. Where the Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus indicated the highest antibiotic resistance to Nitrofurantoin, Sulfamethoxazole/trimethoprim, Tetracycline, Ciprofloxacin, Metronidazole and also revealed the most sensitivity to Cefixime followed by doxycycline and ceftriaxone.
Conclusions: The obtained results emphasized the emergence of highly resistant bacteria to most of the tested antimicrobials and propose the need for physicians to change their treatment pattern depending on antimicrobial susceptibility results.

Keywords

Antibiotic resistance pattern; Urinary tract infection; Urine culture

Resumen

Introducción: Las infecciones del tracto urinario (ITU) son una de las infecciones bacterianas humanas más comunes que encuentran los médicos. El riesgo de microbios resistentes está surgiendo como resultado del uso excesivo de tratamientos con antibióticos. La presencia de patógenos con mayor resistencia a los agentes antimicrobianos dificulta el tratamiento de las infecciones urinarias. Este estudio tuvo como objetivo determinar la prevalencia de los patógenos que causan las ITU, así como la susceptibilidad a los antibióticos de estos aislados.
Materiales y métodos: Este estudio prospectivo se realizó desde febrero de 2020 hasta abril de 2020; Se recogió un total de 200 muestras de orina de pacientes que asistían diariamente a TMC Libia. Los patógenos bacterianos se determinaron mediante métodos de cultivo bacteriológico y las pruebas de susceptibilidad a los antimicrobianos se realizaron mediante el método de difusión en disco.
Resultados: De 200 muestras, 110 casos tuvieron un cultivo positivo. Los patógenos bacterianos dominantes fueron Gram-negativos con Escherichia coli (49, 55.68%), seguidos de Klebsiella pneumonia (18, 20.46%), Pseudomonas aeruginosa (9, 10.23%), Proteus mirabilis (8, 9.09%), Enterobacter aerogenes (2, 2.27%). %), Citrobacter freundii (2, 2.27%). Las bacterias grampositivas fueron Staphylococcus aureus (20, 90.91%) seguido de S. saprophyticus, (2, 9.01%) de las cepas del aislado. El uropatógeno aislado mostró niveles aumentados de resistencia a los antibióticos. Donde Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus indicaron la mayor resistencia a los antibióticos a la nitrofurantoína, sulfametoxazol/trimetoprima, tetraciclina, ciprofloxacina, metronidazol y también revelaron la mayor sensibilidad a la cefixima seguida de la doxiciclina y la ceftriaxona.
Conclusiones: Los resultados obtenidos enfatizan la aparición de bacterias altamente resistentes a la mayoría de los antimicrobianos probados y proponen la necesidad de que los médicos cambien su patrón de tratamiento en función de los resultados de susceptibilidad antimicrobiana.

Palabras clave

Patrón de resistencia a antibióticos; Infección del tracto urinario; Urocultivo

References

1. Vasudevan R. Emergence of UTI causing Staphylococcus aureus as a superbug: Has the pathogen reduced the options of antimicrobial agents for treatment. EC Microbiol. 2015;1:88-112.
2. Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin North Am. 2014;28(1):1-13. doi: 10.1016/j.idc.2013.09.003.
3. Zone CP, Guide S. Antimicrobial resistance and urinary tract infections in the community. Signs. 2017;6:3531-93.
4. Mody L, Juthani-Mehta M. Urinary tract infections in older women: a clinical review. JAMA. 2014;311(8):844-54. doi: 10.1001/jama.2014.303.
5. Sharma A, Chandraker S, Patel VK, Ramteke P. Antibacterial Activity of Medicinal Plants Against Pathogens causing Complicated Urinary Tract Infections. Indian J Pharm Sci. 2009;71(2):136-9. doi: 10.4103/0250-474X.54279.
6. O'Grady MC, Barry L, Corcoran GD, Hooton C, Sleator RD, Lucey B. Empirical treatment of urinary tract infections: how rational are our guidelines? J Antimicrob Chemother. 2019;74(1):214-7. doi: 10.1093/jac/dky405.
7. Seifu WD, Gebissa AD. Prevalence and antibiotic susceptibility of Uropathogens from cases of urinary tract infections (UTI) in Shashemene referral hospital, Ethiopia. BMC Infect Dis. 2018;18(1):30. doi: 10.1186/s12879-017-2911-x.
8. Butler CC, Hawking MK, Quigley A, McNulty CA. Incidence, severity, help seeking, and management of uncomplicated urinary tract infection: a population-based survey. Br J Gen Pract. 2015;65(639):e702-7. doi: 10.3399/bjgp15X686965.
9. Butler CC, Francis N, Thomas-Jones E, Llor C, Bongard E, Moore M, et al. Variations in presentation, management, and patient outcomes of urinary tract infection: a prospective four-country primary care observational cohort study. Br J Gen Pract. 2017;67(665):e830-e841. doi: 10.3399/bjgp17X693641.
10. Sharif MR, Alizargar J, Sharif A. (2013). Prevalence and antibiotic susceptibility pattern of microbial agents that cause urinary tract infection. Middle East j Sci Res. 2013;17(11):1512-5.
11. World Organization Health. Antimicrobial Resistance: Global Report on Surveillance 2014. Available from: https://www.who.int/drugresistance/documents/surveillancereport/en/ (accessed March 2021).
12. Gágyor I, Bleidorn J, Kochen MM, Schmiemann G, Wegscheider K, Hummers-Pradier E. Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial. BMJ. 2015;351:h6544. doi: 10.1136/bmj.h6544.
13. Gilbert JA, Blaser MJ, Caporaso JG, Jansson JK, Lynch SV, Knight R. Current understanding of the human microbiome. Nat Med. 2018;24(4):392-400. doi: 10.1038/nm.4517.
14. Sewify M, Nair S, Warsame S, Murad M, Alhubail A, Behbehani K, et al. Prevalence of Urinary Tract Infection and Antimicrobial Susceptibility among Diabetic Patients with Controlled and Uncontrolled Glycemia in Kuwait. J Diabetes Res. 2016;2016:6573215. doi: 10.1155/2016/6573215.
15. Clinical and Laboratory standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. 26th ed. Clinical and Laboratory Standards Institute: Pennsylvania; 2016.
16. Karstens L, Asquith M, Caruso V, Rosenbaum JT, Fair DA, Braun J, et al. Community profiling of the urinary microbiota: considerations for low-biomass samples. Nat Rev Urol. 2018;15(12):735-49. doi: 10.1038/s41585-018-0104-z.
17. 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 infections in Northwestern Libya. Libyan J Med. 2015;10:26412. doi: 10.3402/ljm.v10.26412.
18. 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 Hospital, Libya. Asian Pac J Trop Med. 2016;9(8):771-6. doi: 10.1016/j.apjtm.2016.06.011.
19. Salim FA, Murad SK Elbareg AM. Isolation of bacterial pathogens causing urinary tract infections and their antimicrobial susceptibility pattern among patients at Misurata teaching hsospital, Libya. Microbiol. Infect Dis. 2017;1(2):1-5.
20. Elsayah K, Atia A, Bkhait N. Antimicrobial resistance pattern of bacteria isolated from patients with urinary tract infection in Tripoli city, Libya. Asian J Pharm Sci. 2017;7(4):1751-5.
21. Reis AC, Santos SR, Souza SC, Saldanha MG, Pitanga TN, Oliveira RR. Ciprofloxacin resistance pattern among bacteria isolated from patients with community-acquired urinary tract infection. Rev Inst Med Trop Sao Paulo. 2016;58:53. doi: 10.1590/S1678-9946201658053.
22. Bientinesi R, Murri R, Sacco E. Efficacy and safety of levofloxacin as a treatment for complicated urinary tract infections and pyelonephritis. Expert Opin Pharmacother. 2020;21(6):637-44. doi: 10.1080/14656566.2020.1720647.
23. Mostafa MM, Albakosh AM, Alrtail A, Rzeg MM and Aboukay AM. Etiology of uropathogenic bacteria in patients with urinary tract infection in Zliten, Libya. J Human Applied Sci. 2016;29:16-32.
24. Derese B, Kedir H, Teklemariam Z, Weldegebreal F, Balakrishnan S. Bacterial profile of urinary tract infection and antimicrobial susceptibility pattern among pregnant women attending at Antenatal Clinic in Dil Chora Referral Hospital, Dire Dawa, Eastern Ethiopia. Ther Clin Risk Manag. 2016;12:251-60. doi: 10.2147/TCRM.S99831.
25. Guermazi-Toumi S, Boujlel S, Assoudi M, Issaoui R, Tlili S, Hlaiem ME. Susceptibility profiles of bacteria causing urinary tract infections in Southern Tunisia. J Glob Antimicrob Resist. 2018;12:48-52. doi: 10.1016/j.jgar.2017.09.004.
26. Mihankhah A, Khoshbakht R, Raeisi M, Raeisi V. Prevalence and antibiotic resistance pattern of bacteria isolated from urinary tract infections in Northern Iran. J Res Med Sci. 2017;22:108. doi: 10.4103/jrms.JRMS_889_16.
27. Ayoyi AO, Kikuvi G, Bii C, Kariuki S. Prevalence, aetiology and antibiotic sensitivity profile of asymptomatic bacteriuria isolates from pregnant women in selected antenatal clinic from Nairobi, Kenya. Pan Afr Med J. 2017;26:41. doi: 10.11604/pamj.2017.26.41.10975.
28. Okonko IO, Ijandipe LA, Ilusanya OA, Donbraye-Emmanuel OB, Ejembi J, Udeze AO, et al. Incidence of urinary tract infection (UTI) among pregnant women in Ibadan, South-Western Nigeria. Afr J Biotechnol. 2009;8(23):6649-57.
29. Prakash D, Saxena RS. Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of meerut city, India. ISRN Microbiol. 2013;2013:749629. doi: 10.1155/2013/749629.
30. Sood S, Gupta R. Antibiotic resistance pattern of community acquired uropathogens at a tertiary care hospital in jaipur, rajasthan. Indian J Community Med. 2012;37(1):39-44. doi: 10.4103/0970-0218.94023.
31. Lammie SL, Hughes JM. Antimicrobial Resistance, Food Safety, and One Health: The Need for Convergence. Annu Rev Food Sci Technol. 2016;7:287-312. doi: 10.1146/annurev-food-041715-033251.


Submitted date:
04/01/2021

Reviewed date:
05/03/2021

Accepted date:
05/24/2021

Publication date:
06/04/2021

60ba3195a953957c896a7253 iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections