Determining the Prevalence of Upper and Lower Urinary Tract Infections' Pathogens and Their Antibiotic Susceptibility Profile for Adult Patients in Al-Diwaniya, Iraq

Abstract

Until today, one of the leading predominant infections is Urinary tract infection (UTI). It exerts a huge burden on health systems worldwide each year. Treating UTI empirically with antimicrobials improves morbidity rates. This study aims to assess the prevalence of UTI associated bacteria in adult patients and to determine their antibiotic susceptibility profile. A retrospective study was conducted for adult outpatients who visited Al- Diwaniya tertiary hospitals from January 2020 till February 2022 to review their medical and lab records in addition to sociodemographic data. A total of 256 patients' records included of which 204 (79.7%) belong to females and 52 (20.3%) were males with average age of 39.22±17.10 years. The predominant organisms' isolates were Staphylococcus spp. found in 100 records (39.1%), Escherichia coli (E. coli) demonstrated in 90 records (35.2%), and Klebsiella spp. revealed in 23 records (9%). Staphylococcus spp. showed full resistance to cefepime and high resistance to ampicillin (92.9%) followed by ceftazidime (87.5%), and were highly sensitive to vancomycin. The higher resistance profile of E. coli was to ampicillin (97.9%) and ceftriaxone (81.3%) while was highly susceptible to meropenem (97.9%) and amikacin (97.6%). Additionally, Klebsiella spp. was highly susceptible to nitrofurantoin (78.6%), while was completely resistant to ampicillin. This study presents Staphylococcus spp. as the most prevalent gram-positive uropathogen and E. coli as the most prevalent gramnegative bacteria with multidrug resistance profile to commonly used antimicrobials which is an alarming situation to implement an immediate effective stewardship program.