Antibiotic resistance pattern and phylogenetic groups of the uropathogenic Escherichia coli isolates from urinary tract infections in Hamedan, west of Iran

Background and Objectives: Escherichia coli is the most common causative agent of urinary tract infections (UTIs) in 90-80% of patients in all age groups. Phylogenetic groups of these bacteria are variable and the most known groups are A, B1, B2 and D. The present study aimed to evaluate the phylogenetic groups of E. coli samples obtained from UTIs and their relation with antibiotic resistance patterns of isolates. Materials and Methods: In this study 113 E. coli isolates were isolated from distinct patients with UTIs referred to Hamadan hospitals. After biochemical and molecular identification of the isolates, typing and phylogenetic grouping of E. coli strains were performed using multiplex PCR targeting chu, yjaA and TSPE4.C2 genes. The anti-microbial susceptibility of the isolates to amikacin, ampicillin, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid, ciprofloxacin, cefotaxime, imipenem, aztreonam, gentamicin, meropenem, nitrofurantoin, nalidixic acid and cefazolin was determined using disk diffusion method. Results: Of 113 isolates, 50 (44.2%), 35 (31%), 23 (20.4%) and 5 (4.4%) of samples belonged to group B2, group D, group A and group B1 phylogenetic groups respectively. All isolates were susceptible to meropenem, imipenem (100%), followed by amikacin (99.1%). The highest resistance rates were observed against ampicillin (74.3%) and nalidixic acid (70.8%). Correlation between phylogenetic groups and antibiotic susceptibilities was significant only with co-amoxiclav (P = 0.006), which had the highest resistance in phylogenetic group A. Conclusion: Prevalence of different phylogroup and resistance associated with them in E. coli samples could be variable in each region. Therefore, investigating of these items in E. coli infections, could be more helpful in selecting the appropriate antibiotic treatment and epidemiological studies.

Download Full-text

Prevalence of Resistance to Quinolone and Fluoroquinolone Antibiotics and Screening of qnr Genes Among Escherichia coli Isolates From Urinary Tract Infection

International Journal of Enteric Pathogens ◽

10.15171/ijep.2017.24 ◽

2017 ◽

Vol 5 (4) ◽

pp. 100-105 ◽

Cited By ~ 1

Author(s):

Mohadese Amiri ◽

Maziar Jajarmi ◽

Reza Ghanbarpour

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Nalidixic Acid ◽

Diffusion Method ◽

Biochemical Tests ◽

Phylogenetic Groups ◽

Disk Diffusion Method ◽

E Coli ◽

Fluoroquinolone Antibiotics ◽

Tract Infections

Background: Antibiotic resistance (AR) is an important challenge in prevention, treatment and control of infectious diseases and is a public health threat for human. Escherichia coli strains are the major causes of urinary tract infections (UTIs). Objective: This research aimed to determine prevalence of resistance to quinolone and fluoroquinolone antibiotics and screen qnr genes among E. coli isolates from UTIs. Materials and Methods: A total of 105 E. coli isolates were obtained from UTI cases in Bojnord city (northeast of Iran) and confirmed by biochemical tests. All strains were studied to determine their resistance to 3 antibiotics including ciprofloxacin, nalidixic acid, and levofloxacin via disk diffusion method. Moreover, the frequency of qnrA, qnrB and qnrS genes and phylogroups was studied by conventional Polymerase chain reaction (PCR). Results: In this study, prevalence of phenotypic AR to ciprofloxacin, nalidixic acid and levofloxacin was 47.6%, 44.8% and 38.1%, respectively. Three isolates were positive for qnrS and 1 isolate was positive for qnrA. Seven phylogenetic groups were also identified as follows: 18% A0, 6.7% A1, 7.6% B1, 1.9% B22, 23.8% B23, 15.3% D1 and 26.7% D2. Conclusion: Prevalence of qnr genes was very low; thus, other types of qnr and plasmid-mediated quinolone resistance genes were probably responsible for the resistance. Phenotypic AR to the 3 antibiotics was found in approximately half of E. coli strains. It is strongly recommended that antibiogram tests should be done before prescribing the ciprofloxacin, nalidixic acid and levofloxacin for UTIs.

Download Full-text

Detection of plasmid-mediated qnr genes among the quinolone-resistant Escherichia coli isolates in Iran

The Journal of Infection in Developing Countries ◽

10.3855/jidc.3746 ◽

2014 ◽

Vol 8 (07) ◽

pp. 818-822 ◽

Cited By ~ 12

Author(s):

Farzaneh Firoozeh ◽

Mohammad Zibaei ◽

Younes Soleimani-Asl

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Quinolone Resistance ◽

Diffusion Method ◽

Chain Reaction ◽

Disk Diffusion Method ◽

E Coli ◽

Polymerase Chain ◽

Tract Infections

Introduction: Plasmid-mediated quinolone resistance, which complicates treatment, has been increasingly identified in Escherichia coli isolates worldwide. The purpose of this study was to identify the plasmid-mediated qnrA and qnrB genes among the quinolone-resistant Escherichia coli isolated from urinary tract infections in Iran. Methodology: A total of 140 Escherichia coli isolates were collected between March and October 2012 from urinary tract infections in Khorram Abad, Iran. All isolates were tested for quinoloe resistance using the disk diffusion method. Also, all quinolone-resistant isolates were screened for the presence of the qnrA and qnrB genes by polymerase chain reaction. Minimum inhibitory concentrations (MICs) of ciprofloxacin for the qnr-positive isolates were determined. Results: One hundred sixteen (82.8%) of 140 Escherichia coli isolates were nalidixic acid-resistant; among them, 14 (12.1%) and 9 (7.8%) were qnrA and qnrB-positive, respectively. Two quinolone-resistant isolates harbored both qnrA and qnrB. Among 63 ciprofloxacin-resistant isolates, 14 (22.2%) and 9 (14.3%) were found to carry qnrA and qnrB genes, respectively. The ciprofloxacin MIC range was 0.25–512 μg/mL for 23 qnr-positive Escherichia coli isolates, 18 of which had MICs values of 4–512 μg/mL. Conclusion: Our study shows that the frequency of plasmid-mediated quinolone resistance genes among E. coli isolates in Iran is high.

Download Full-text

Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams

The Journal of Infection in Developing Countries ◽

10.3855/jidc.361 ◽

2007 ◽

Vol 1 (03) ◽

pp. 257-262 ◽

Cited By ~ 25

Author(s):

Samuel Kariuki ◽

Gunturu Revathi ◽

John Corkill ◽

John Kiiru ◽

Joyce Mwituria ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Nalidixic Acid ◽

Urinary Tract Infections ◽

Acid Resistance ◽

Beta Lactam ◽

E Coli ◽

Extended Spectrum ◽

Tract Infections ◽

Multiple Drugs

Background: Uropathogenic Escherichia coli are increasingly becoming resistant to flouroquinolones and to other commonly available antimicrobials. We sought to investigate the genetic basis for fluoroquinolone and extended spectrum beta-lactam (ESBL) resistance in 17 fluoroquinolone-resistant (MIC of levofloxacin and ciprofloxacin >32 μg/ml) E. coli isolated from patients with urinary tract infections (UTIs). Methods: We applied PCR and Pulsed Field Gel Electrophoresis (PFGE) to characterize resistance genes and to determine clonal relatedness of strains, respectively. Results: Twelve of the 17 E. coli were resistant to multiple drugs, including ampicillin, co-amoxyclav, cefotaxime, ceftriaxone, ceftazidime and gentamicin and nalidixic acid and produced plasmid-mediated CTX-M-15 type ESBLs and CMY-2 AmpC type enzymes. The other 5 E. coli that were non-ESBL-producing were multiply resistant to ampicillin, nitrofurantoin, cefoxitin, nalidixic acid. Resistance to fluoroquinolones resulted from a combination of the presence of qnrA, qnrB, ciprofloxacin acetylating enzyme designated aac(6’)-1b-cr, and mutations in the two amino acid substitutions; 83 Serine (TCG) to Leucine (TTG) and 87 Aspartic acid (GAC) to Asparagine (AAC). Conclusion: Antibiogram patterns and PFGE of E. coli showed that these were community acquired UTI caused by pockets of clonally-related and some discreet strain types. Plasmid-mediated CTX-M-15 beta-lactamases and CMY-2 AmpC enzymes and fluoroquinolone resistant E. coli are becoming increasingly prevalent in hospitals in Kenya, posing a major challenge in the management of UTIs.

Download Full-text

Urine Microbial Landscape in Children with Urinary Tract Infections in Ryazan and Ryazan Region

Doctor Ru ◽

10.31550/1727-2378-2021-20-10-48-53 ◽

2021 ◽

Vol 20 (10) ◽

pp. 48-53

Author(s):

N.A. Belykh ◽

◽

S.V. Tereschenko ◽

N.A. Anikeeva ◽

S.S. Kantutis ◽

...

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

Patient Specific ◽

E Coli ◽

Resistance Determinants ◽

Study Results ◽

Tract Infections

Study Objective: To study a spectrum of uropathogens and their sensitivity to antimicrobials in urinary tract infections (UTIs) in children in Ryazan and Ryazan Region. Study Design: retrospective study. Materials and Methods. We conducted a retrospective local laboratory monitoring of urinary microflora and analysed its sensitivity to antimicrobials in 111 patients aged 2 months to 17 years old who were undergoing traditional UI therapy in 2020. The study group comprised 75 (67.6%) girls and 36 (32.4%) boys. Pathogen isolation and type identification were performed using urine specimens collected in sterile disposable plastic containers prior to antimicrobial therapy. Material was delivered for analysis within 2 hours from collection. For testing of pathogen sensitivity to antimicrobials, we used the phenotyping diffusion test and an analytical test for carbapenems inactivation. Study Results. Prevailing causative agents of UIs were Escherichia coli (50.4%) and Klebsiella pneumoniae (14.4%). Resistance determinants were found in 9.0% and 2.7% of Е. соli and K. pneumoniae urological strains, respectively. The main mechanism of resistivity was production of wide spectrum plasmid β-lactamases. The highest activity in E. coli was demonstrated by generation III–IV cephalosporins, aminoglycosides, fosfomicin (100%), nitrofurantoin (91.3%), and aminopenicillins (76.1–86.9%). For K. pneumoniae, generation III–IV cephalosporins and aminoglycosides were most potent (100%). All resistant pathogens were sensitive to cefoperazone sulbactam, meropenem, imipenem, aminoglycosides (100%); tigecycline, nitrofurantoin, and fosfomicin were most potent against E. coli. Conclusion. Children with UIs in Ryazan Region had mostly gram-negative bacteria in their urine (85.6%), Enterobacteralеs (81.1%) being a prevailing type. Antimicrobials resistance determinants were quite rare (17.8%) in these urine isolates; all of them were class A ЕSBL producers. These characteristic features of antibiotic resistance of uropathogenic enterobacteria strains allow using β-lactam antibiotics in empiric initial treatment and emphasising the need in patient-specific selection of antimicrobials. Keywords: antibacterial therapy, antibiotic resistance, children, urinary tract infections, Escherichia coli, Klebsiella pneumoniae.

Download Full-text

Detection of Phylogenetic Groups and Drug Resistance Genes of Escherichia coli Causing Urinary Tract Infection in Southwest Iran

Jundishapur Journal of Microbiology ◽

10.5812/jjm.112547 ◽

2021 ◽

Vol 14 (2) ◽

Author(s):

Mostafa Boroumand Boroumand ◽

Mohsen Naghmachi ◽

Mohammad Amin Ghatee

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Resistance Genes ◽

Antibiotic Resistance Genes ◽

Phylogenetic Group ◽

Phylogenetic Groups ◽

E Coli ◽

Pcr Method ◽

Tract Infections

Background: Many bacteria can cause urinary tract infections (UTIs), among which Escherichia coli is the most common causative agent. E. coli strains are divided into eight phylogenetic groups based on the new Quadroplex-PCR method, which are different in terms of patterns of resistance to antibiotics, virulence, and environmental characteristics. Objectives: This study aimed to determine the phylogenetic groups and the prevalence of drug resistance genes in E. coli strains causing UTIs. Methods: In this descriptive cross-sectional study, 129 E. coli isolates obtained from the culture of patients with UTIs were evaluated for phylogenetic groups using the new method of Clermont et al. The identification of phylogenetic groups and antibiotic resistance genes was performed using the multiplex polymerase chain reaction (PCR) method. Results: In this study, concerning the distribution of phylogenetic groups among E. coli isolates, the phylogenetic group B2 (36.4%) was the most common phylogenetic group, followed by phylogroups C (13.2%), clade I (10.1%), D (9.3%), and A (3.1%) while groups B1 and F were not observed in any of the isolates, and 20.2% had an unknown state. Also, out of 129 E. coli isolates, the total frequency of tetA, tetB, sul1, sul2, CITM, DfrA, and qnr resistance genes was 59.7%, 66.7, 69, 62, 30.2, 23.3, and 20.2%, respectively. In this study, there was a significant relationship between antibiotics (P = 0.026), cefotaxime (P = 0.003), and nalidixic acid (P = 0.044) and E. coli phylogenetic groups. No significant relationship was observed between E. coli phylogenetic groups and antibiotic resistance genes. Conclusions: The results of this study showed that strains belonging to group B2 had the highest prevalence among other phylogroups, and also, the frequency of antibiotic resistance genes and drug-resistant isolates had a higher prevalence in this phylogroup. These results show that phylogroup B2 has a more effective role in causing urinary tract infections compared to other phylogroups, and this phylogroup can be considered a genetic reservoir of antibiotic resistance.

Download Full-text

Selection and co-selection of antibiotic resistances among Escherichia coli by antibiotic use in primary care: an ecological analysis

10.1101/573360 ◽

2019 ◽

Cited By ~ 1

Author(s):

Koen B Pouwels ◽

Berit Muller-Pebody ◽

Timo Smieszek ◽

Susan Hopkins ◽

Julie V Robotham

Keyword(s):

Escherichia Coli ◽

Primary Care ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Respiratory Tract ◽

Urinary Tract Infections ◽

Respiratory Tract Infections ◽

Antibiotic Use ◽

E Coli ◽

Tract Infections

AbstractThe majority of studies that link antibiotic usage and resistance focus on simple associations between the resistance against a specific antibiotic and the use of that specific antibiotic. However, the relationship between antibiotic use and resistance is more complex. Here we evaluate which antibiotics, including those mainly prescribed for respiratory tract infections, are associated with increased resistance among Escherichia coli isolated from urinary samples.Monthly primary care prescribing data were obtained from National Health Service (NHS) Digital. Positive E. coli records from urine samples in English primary care (n=888,207) between April 2014 and January 2016 were obtained from the Second Generation Surveillance System. Elastic net regularization was used to evaluate associations between prescribing of different antibiotic groups and resistance against amoxicillin, cephalexin, ciprofloxacin, co-amoxiclav and nitrofurantoin at the clinical commissioning group (CCG) level. England is divided into 209 CCGs, with each NHS practice prolonging to one CCG.Amoxicillin prescribing (measured in DDD/ 1000 inhabitants / day) was positively associated with amoxicillin (RR 1.03, 95% CI 1.01 – 1.04) and ciprofloxacin (RR 1.09, 95% CI 1.04 – 1.17) resistance. In contrast, nitrofurantoin prescribing was associated with lower levels of resistance to amoxicillin (RR 0.92, 95% CI 0.84 – 0.97). CCGs with higher levels of trimethoprim prescribing also had higher levels of ciprofloxacin resistance (RR 1.34, 95% CI 1.10 – 1.59).Amoxicillin, which is mainly (and often unnecessarily) prescribed for respiratory tract infections is associated with increased resistance against various antibiotics among E. coli causing urinary tract infections. Our findings suggest that when predicting the potential impact of interventions on antibiotic resistances it is important to account for use of other antibiotics, including those typically used for other indications.Author summaryAntibiotic resistance is increasingly recognised as a threat to modern healthcare. Effective antibiotics are crucial for treatment of serious bacterial infections and are necessary to avoid that complicated surgical procedures and chemotherapy becoming life-threatening. Antibiotic use is one of the main drivers of antibiotic resistance. The majority of antibiotic prescriptions are prescribed in primary care, however, a large proportion of these antibiotic prescriptions are unnecessary. Understanding which antibiotics are causing antibiotic resistance to what extent is needed to prevent under- or over-investment in interventions lowering use of specific antibiotics, such as rapid diagnostic tests for respiratory tract infection.We have statistically evaluated which antibiotics are associated with higher and lower levels of antibiotic resistance against common antibiotics among Escherichia coli bacteria sampled from the urinary tract by comparing antibiotic prescribing and resistance in different geographical areas in England. Our model shows that amoxicillin, the most commonly used antibiotic in England and mainly used for respiratory tract infections, is associated with increased resistance against several other antibiotics among bacteria causing urinary tract infections. The methods used in this study, that overcome several of the limitations of previous studies, can be used to explore the complex relationships between antibiotic use and antibiotic resistance in other settings.

Download Full-text

Bacterial Profile of Urinary Tract Infections: Evaluation of Biofilm Formation and Antibiotic Resistance Pattern of Uropathogenic Escherichia coli

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.14.4.33 ◽

2020 ◽

Vol 14 (4) ◽

pp. 2577-2584

Author(s):

Tariq Ahmad Shah ◽

P. Preethishree ◽

Ashwini ◽

Vidya Pai

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Biofilm Formation ◽

Urine Samples ◽

Diffusion Method ◽

E Coli ◽

Biofilm Production ◽

Tract Infections

Urinary tract infection (UTI) is one of the most common complaints in the outpatient clinic and a major health problem owing to the emergence of antibiotic resistance and biofilm formation. The objective of this study was to isolate and identify the causative bacterial agent of UTI and detect in vitro biofilm formation by Escherichia coli and investigate its correlation with antibiotic resistance. Urine samples from 519 patients with suspected UTIs were collected and processed by conventional microbiological procedures. Antimicrobial susceptibility testing for E. coli isolates was performed on Mueller Hinton agar (MHA) plates using the Kirby-Bauer disk diffusion method. Biofilm production was evaluated using the tissue culture plate method. Of 519 urine samples, 115 (22.1%) showed significant bacteriuria. The most common isolate was E. coli (n=57, 49.6%), followed by Klebsiella spp. (n=23, 20%). All E. coli isolates were evaluated for their ability to form biofilms in vitro. Of 57 isolates, 50 (87.7%) were biofilm producers and 7 (12.3%) were non-biofilm producers. Antibiogram of E. coli isolates revealed the highest resistance to ampicillin (96.5%) and nitrofurantoin (91.2%), followed by amoxyclav (82.5%), ceftazidime (73.7%), cefepime (71.9%), and tetracycline (71.9%). A significant association (p<0.05) was observed between biofilm formation and resistance to amoxyclav, ceftazidime, cefepime, imipenem, and nitrofurantoin. A significant correlation was noted between biofilm production and antibiotic resistance. Hence, screening of all isolates of uropathogenic E. coli for biofilm production and studying their antibiogram would allow appropriate choice of antibiotic therapy.

Download Full-text

ANTIBIOTIC SUSCEPTIBILITY OF BACTERIAL STRAINS, WITH SPECIAL REFERENCE TO ESCHERICHIA COLI ISOLATED FROM URINARY TRACT INFECTIONS IN RURAL MAHARASHTRA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i1.14871 ◽

2016 ◽

Vol 10 (1) ◽

pp. 202

Author(s):

Sunil Shivaputrayya Gidamudi ◽

Gaurav V Salunke

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Multiple Antibiotic Resistance ◽

Bacterial Strains ◽

Cross Sectional ◽

E Coli ◽

Sensitivity Pattern ◽

Tract Infections

ABSTRACTObjective: The objective of this study was to find out the etiology of urinary tract infections (UTIs) in patients attending B.K.L. Walawalkar Hospital,Dervan and to determine their antibiotic sensitivity pattern to currently used antimicrobial agents.Methods: A cross-sectional study was conducted in a rural hospital of Konkan Maharashtra, and urine samples were collected from368 clinically - suspected cases of UTIs using the mid-stream “clean catch” method and was tested and cultured using standard procedures. Antimicrobialsusceptibility test (AST) was performed for the isolated pathogens according to the Clinical and Laboratory Standards Institute guidelines.Results: Escherichia coli (54.84%) was the most prevalent uropathogen. 76.47% of the isolated E. coli were found to be extended spectrum betalactamase producers. A higher prevalence rate of resistance was seen among E. coli to the commonly prescribed antibiotic agents. 32 (94.11%) of34 E. coli isolates recovered had multiple antibiotic resistance (MAR), with 16 isolates (50%) possessing MAR indices of 0.6.Conclusion: The study indicates the isolated microorganisms in UTI showed very high resistance to the commonly prescribed antimicrobial drugs.This suggests the monitoring and rational use of the antimicrobial agents.Keywords: Mid-stream, Culture, Uropathogen, Resistance, Multiple antibiotic resistance.

Download Full-text

Antibiotic Susceptibility and Molecular Characterization of Uropathogenic Escherichia coli Associated with Community-Acquired Urinary Tract Infections in Urban and Rural Settings in South Africa

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed5040176 ◽

2020 ◽

Vol 5 (4) ◽

pp. 176

Author(s):

Purity Z. Kubone ◽

Koleka P. Mlisana ◽

Usha Govinden ◽

Akebe Luther King Abia ◽

Sabiha Y. Essack

Keyword(s):

Escherichia Coli ◽

South Africa ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Resistance Genes ◽

Multidrug Resistant ◽

Uropathogenic Escherichia Coli ◽

Diffusion Method ◽

E Coli ◽

Tract Infections

We investigated the phenotypic and genotypic antibiotic resistance, and clonality of uropathogenic Escherichia coli (UPEC) implicated in community-acquired urinary tract infections (CA-UTIs) in KwaZulu-Natal, South Africa. Mid-stream urine samples (n = 143) were cultured on selective media. Isolates were identified using the API 20E kit and their susceptibility to 17 antibiotics tested using the disk diffusion method. Extended-spectrum β-lactamases (ESBLs) were detected using ROSCO kits. Polymerase chain reaction (PCR) was used to detect uropathogenic E. coli (targeting the papC gene), and β-lactam (blaTEM/blaSHV-like and blaCTX-M) and fluoroquinolone (qnrA, qnrB, qnrS, gyrA, parC, aac(6’)-Ib-cr, and qepA) resistance genes. Clonality was ascertained using ERIC-PCR. The prevalence of UTIs of Gram-negative etiology among adults 18–60 years of age in the uMgungundlovu District was 19.6%. Twenty-six E. coli isolates were obtained from 28 positive UTI samples. All E. coli isolates were papC-positive. The highest resistance was to ampicillin (76.9%) and the lowest (7.7%) to amoxicillin/clavulanic acid and gentamycin. Four isolates were multidrug-resistant and three were ESBL-positive, all being CTX-M-positive but SHV-negative. The aac(6’)-Ib-cr and gyrA were the most detected fluoroquinolone resistance genes (75%). Isolates were clonally distinct, suggesting the spread of genetically diverse UPEC clones within the three communities. This study highlights the spread of genetically diverse antibiotic-resistant CA-UTI aetiologic agents, including multidrug-resistant ones, and suggests a revision of current treatment options for CA-UTIs in rural and urban settings.

Download Full-text

Antibiotic resistance pattern of Escherichia coli isolates from outpatients with urinary tract infections in Somalia

The Journal of Infection in Developing Countries ◽

10.3855/jidc.12189 ◽

2020 ◽

Vol 14 (03) ◽

pp. 284-289 ◽

Cited By ~ 1

Author(s):

Malyun Adam Mohamed ◽

Omar Abdifetah ◽

Fatima Abdullahi Hussein ◽

Sa’adia Abdullahi Karie

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Resistance Rate ◽

Resistance Pattern ◽

E Coli ◽

Antibiotic Resistance Pattern ◽

History Of ◽

Tract Infections

Introduction: Several studies suggest increasing rates of antibiotic resistance among adult populations with Urinary tract infections (UTI). Escherichia coli (E. coli), is the predominant bacterium both in the community and in hospital environments causing uropathogenic infections. This study aimed to estimate the common uropathogen bacteria that cause UTI among outpatients as well as to determine the antibiotic resistance pattern of E. coli isolates among outpatients with UTI infections at Shaafi hospital, Mogadishu, Somalia. Methodology: A cross-sectional study was conducted at Shaafi Hospital, Mogadishu, Somalia. A total of 128 samples were collected from outpatients suspected of UTI and tested through bacteriological investigations and antimicrobial susceptibility tests following the Kirby-Bauer agar disc diffusion method. Results: E. coli was isolated in 34 (41%) out of the total 83 samples that showed growth followed by Staphylococcus aureus 22 (26.5%), Pseudomonas aeruginosa, 13 (15.7%), Klebsiella pneumoniae 8 (9.6 %) and Proteus spp. 6 (7.2%). E. coli was highly sensitive to nitrofurantoin, 29 (85.3%), and ciprofloxacin (n = 23, 67.6%), and had the highest resistance rate of ceftriaxone, 33 (97.1%). The odds of having UTI were higher in patients with a history of UTI (Odds ratio OR = 0.211, 95% confidence interval CI: 0.080, 0.553) and history of antibiotic use (OR = 0.322, 95% CI: 0.113, 0.917). Increased resistance rate of E. coli against cephalosporins could be due to its excessive use as empirical therapy. Conclusion: The study indicates that outpatients with UTI could be at high risk of antibiotic resistance, suggesting regular surveillance and monitoring of antibiotics.

Download Full-text