Prevalence and Antimicrobial Resistance Pattern of uropathogenic Escherichia coli at a tertiary care hospital: A retrospective study
,
Abstract
Background: Uropathogenic Escherichia coli (UPEC) is the most common cause of urinary tract infection in humans including cystitis and pyelonephritis. Antimicrobial resistance (AMR) in UPEC is one of the global public challenges that is due to prevalent use of antibiotics in healthcare setting. Therefore, the purpose of this study is to investigate the frequency and antibiotic resistance pattern of UPEC isolated from patients admitted to Modares Hospital in Saveh, Iran.
Methods& Materials: In this study, in total 633 isolates were evaluated. UPEC isolates were obtained from patients with urinary tract infection and identified using conventional microbiological protocols. Antibiotic resistance pattern of UPEC against different antibiotic were determined using disk diffusion method. SPSSTM software was used for statistical analysis.
Results: In this study, the most sample was related to outpatients and the lowest sample was related to the CCU wards. The highest antibiotic resistance showed against cephalothin (63.8%) and nalidixic acid (62.2%) antibiotics. The highest effective antibiotics for the tested UPEC was nitrofurantoin (90.7%) and gentamicin (77.3%). Cephalothin and nalidixic acid in hospitalized patients in ICU and emergency wards, respectively, showed the highest antibiotic resistance. Out of 633 UPEC, the rate of Multi Drug Resistant (MDR) isolates were 343 (54.2%).
Conclusion: The result of this study highlighted the role of UPEC as one of the important cause of UTI in individuals. Also, nitrofurantoin then gentamicin are the most effective antibiotics against UPEC infections. Logical prescription of antibiotics and infection control strategies are needed for prevention and control of nosocomial infections especially urinary tract infection.
2. Zagaglia C, Ammendolia MG, Maurizi L, et al. Urinary tract infections caused by uropathogenic Escherichia coli strains—new strategies for an old pathogen. Microorganisms 2022; 10(7):1425.
3. Rezatofighi SE, Mirzarazi M, Salehi M. Virulence genes and phylogenetic groups of uropathogenic Escherichia coli isolates from patients with urinary tract infection and uninfected control subjects: a case-control study. BMC Infect Dis 2021; 21:1-11.
4. Bunduki GK, Heinz E, Phiri VS, et al. Virulence factors and antimicrobial resistance of uropathogenic Escherichia coli (UPEC) isolated from urinary tract infections: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:1-13.
5. Whelan S, Lucey B, Finn K. Uropathogenic Escherichia coli (UPEC)-associated urinary tract infections: the molecular basis for challenges to effective treatment. Microorganisms 2023; 11(9):2169.
6. Wagenlehner F, Nicolle L, Bartoletti R, et al. A global perspective on improving patient care in uncomplicated urinary tract infection: expert consensus and practical guidance. JGAR 2022; 28:18-29.
7. Bojar B, Sheridan J, Beattie R, et al. Antibiotic resistance patterns of Escherichia coli isolates from the clinic through the wastewater pathway. Int J Hyg Environ Health 2021;238:113863.
8. Matinfar S, Ahmadi M, Sisakht AM, et al. Phylogenetic and antibiotics resistance in extended-spectrum B-lactamase (ESBL) Uropathogenic Escherichia coli: An update review. Gene Reports 2021; 23:101168.
9. Dadashpour R, Moghaddam MJM, Salehi Z. Prevalence of non-extended spectrum β-lactamases SHV-1 and TEM-1 or-2 types in multidrug-resistant Enterobacteriaceae in northern Iran. Biologia Futura 2020; 71:419-26.
10. Baldiris-Avila R, Montes-Robledo A, Buelvas-Montes Y. Phylogenetic classification, biofilm-forming capacity, virulence factors, and antimicrobial resistance in uropathogenic Escherichia coli (UPEC). Curr Microbiol 2020; 77:3361-70.
11. Zare M, Vehreschild MJ, Wagenlehner F. Management of uncomplicated recurrent urinary tract infections. BJU Int 2022; 129(6):668-78.
12. Fahim NAE. Prevalence and antimicrobial susceptibility profile of multidrug-resistant bacteria among intensive care units patients at Ain Shams University Hospitals in Egypt—a retrospective study. J Egypt Pub Health Ass 2021; 96(1):1-10.
13. Urban-Chmiel R, Marek A, Stępień-Pyśniak D, et al. Antibiotic resistance in bacteria—A review. Antibiotics 2022; 11(8):1079.
14. PA. W. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing 2023; 33th informational supplement. M100-S33. 2023.
15. Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urology 2019; 11:1756287219832172.
16. Nicolle LE, Gupta K, Bradley SF, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis 2019; 68(10):e83-e110.
17. Okafor NA, Olofin-Olupitan MA, Obumneme OS. Incidence of Urinary Tract Infections Among Female Students of Babcock University, Ilishan-Remo, Ogun State. 2021.
18. 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; 18:1-9.
19. Iliyasu H, Young E, Owuna G, et al. Bacteriuria and Antimicrobial Susceptibility of Escherichia coli Isolated From Urine of Asymptomatic University Students in Keffi, Nigeria. 2012.
20. Rehman K, Fiayyaz F, Khurshid M, et al. Antibiotics and antimicrobial resistance: temporal and global trends in the environment. Antibiotics and Antimicrobial Resistance Genes in the Environment: Elsevier; 2020. p. 7-27.
21. Hadadi M, Malekzadegan Y, Heidari H, et al. Antimicrobial resistance pattern in Escherichia coli isolates obtained from a specialized women and children hospital in Shiraz, Iran: a prevalence study. J Health Sci Surv Sys 2016; 4(4):194-8.
22. Issakhanian L, Behzadi P. Antimicrobial agents and urinary tract infections. Curr Pharma Design 2019; 25(12):1409-23.
23. Shirvani M, Keramati A, Esmaeli M. Evaluating the pattern of antibiotic resistance of urinary tract infection (UTI)-causing bacteria in the urine culture samples of patients in the infectious ward of Imam Khomeini Hospital, Kermanshah, in Iran from 2016–2018. African J Urology 2023; 29(1):32.
24. Sabir S, Anjum AA, Ijaz T, Ali MA, Nawaz M. Isolation and antibiotic susceptibility of E. coli from urinary tract infections in a tertiary care hospital. Pakistan J Med Sci 2014; 30(2):389.
25. Malekzadegan Y, Khashei R, Sedigh Ebrahim-Saraie H, et al. Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients. BMC Infect Dis 2018; 18(1):1-9.
26. Nikzad M, Mirnejad R, Babapour E. Evaluation of antibiotic resistance and biofilm formation ability uropathogenic E. coli (UPEC) Isolated from pregnant women in Karaj. Iranian J Med Microbiol 2021; 15(2):195-211.
27. Pandit R, Awal B, Shrestha SS, et al. Extended-spectrum β-lactamase (ESBL) genotypes among multidrug-resistant uropathogenic Escherichia coli clinical isolates from a teaching hospital of Nepal. Interdis Perspect Infect Dis 2020; 2020.
28. Sharma N, Gupta A, Walia G, et al. Pattern of antimicrobial resistance of Escherichia coli isolates from urinary tract infection patients: A three year retrospective study. J Applied Pharma Sci 2016; 6(1):062-5.
29. Malekzadegan Y, Hadadi M, Ebrahim-Saraie HS, et al. Antimicrobial resistance pattern and frequency of multiple-drug resistant Enterobacter spp. at a tertiary care hospital in Southwest of Iran. JKIMSU 2017; 6(2).
| Files | ||
| Issue | Vol 12 No 2 (2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jmb.v12i2.15624 | |
| Keywords | ||
| Antibiotic Resistance; Urinary Tract Infection Uropathogenic Escherichia coli. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
