Prevalence and Antimicrobial Susceptibility Patterns of Gram-negative Uropathogens Isolated in Public Hospital Establishment «Saad Guermech Saoudi Amar Hmaida» Skikda-Algeria

Abstract

Background: Urinary tract infections (UTIs) are a serious world-wide health problem whose treatment becomes highly difficult due to the emergence of antibiotic-resistant bacterial strains. Aims: Herein, a retrospective study was conducted with the aim to determine the prevalence, the identification of the bacteria responsible of UTIs, and the antimicrobial resistance profile. Study Design: All Patient samples, including either external samples or samples taken from patients admitted to Public Hospital Establishment “Saad Guermech Saoudi Amar Hmaida” in Skikda-Algeria were used in this study for a period extending from January 2018 – March 2020. Methodology: The identification of bacterial strains and the antibiotic susceptibility testing was carried out using Analytical Profile index galleries (API) system and disk diffusion method. Results: Among the 1203 samples, 206 (17.12%) were positive, and 997 (82.88%) were negative for bacterial growth. Regarding the pathogenic strains, 26 (12.62%), and 180 (87.38%) were found respectively, Gram-positive and Gram-negative strains. Among the 180 Gram negative strains, 104 (57.83%) were reported in female patients, 68 (37.72%) were in male patients, and 8 (4.45%) whose gender was not mentioned. The most representative Gram-negative strains are Escherichia coli (E. coli) (43.33%), Klebsiella pneumoniae (K. pneumoniae) (13.33%), Proteus mirabilis (P. mirabilis) (7.77%), Enterobacter sp (E. sp) (6.66%), since the other strains were less frequent. Moreover, 6 bacterial strains belonging to 3 genera (Escherichia, Klebsiella, and Enterobacter) were ESBLs producers with an overall prevalence of 3.33% of pathogenic strains isolated from urine. ESBLs were produced in 4.00%, 5.88%, and 6.25% of E. coli, K. pneumoniae, and E. cloacae strains respectively. Conclusion: E. coli was found to be the most predominant strain, while most of the Gram- negative strains were highly resistant to Amoxicillin/clavulanic acid, Ampicillin, penicillin and tobramycin.