Saudi Journal of Biomedical Research (SJBR)
Volume-3 | Issue-02 | 79-87
Original Research Article
Community and Hospital-Acquired UTI Pathogens: Prevalence and Susceptibility Pattern in Sana'a City, Yemen: The Last Bullet
Hafez Alsumairy, Tawfique K AlZubiery, Talal Alharazi, Mansoor Alkhulaidi, Abdulbasit Ahmed Alghoury, Adel Al-Zubeiry
Published : April 30, 2018
Abstract
Urinary tract infection (UTI) is one of the most common infectious diseases
globally. An increasing antimicrobial resistance among Community-acquired (CA)
and Nosocomial UTI has been rapidly growing. Cross-sectional, analytical and
descriptive study was conducted to investigate the current in vitro susceptibility
pattern of the clinically isolated bacteria among Community and Hospital-acquired
(HA) UTI. Patient data for 421 urine specimens were collected from the case records
during October 2016 to March 2017. Significant growth was yielded from 170 of urine
specimens. Kirby-Bauer disk diffusion method was used for detection antibiotic
susceptibility pattern for all isolates. Of the total 170 (40.4%) culture positive samples,
51.2% and 48.8% were CA and HA UTI respectively. The culture positivity of UTI
among the female was (44.1%) compared to (55.9%) among the male. There was a
significant difference in resistance pattern between CA and Nosocomial UTI. The
distribution of the isolated pathogens were (51.2%) and (48.8%) in CA and HA
respectively. The predominant bacterial isolate was Escherichia coli (43.5%) in both
cases of community and nosocomial UTI. However, Klebsiella pneumoniae (69.0%)
was mostly isolated from HA-UTI while Staphylococcus aureus (80.0%) was mostly
detected in CA-UTI. The recent study revealed high resistant rates of UTI among HA
as compared to CA. This study revealed that more than 90% of HA-UTIs isolated
pathogens were resistant to broad-spectrum Penicillins, Cephalosporins, Quinolones,
and Macrolides. Contrarily, high rates of bacterial sensitivity was found towards
Imipenem (82.9%), Nitrofurantoin (72.4%), Ertapenem (70.7%), and Amikacin
(67.1%). Even if Escherichia coli remains the major pathogen in UTI, the resistance
pattern of CA-UTI is frightening in our country. Nitrofurantoin is the only oral drug
that retained reasonable activity against most UTI pathogens. Imipenem and
Ertapenem remain effective for UTI bacterial isolates. The changing of UTI
etiological agents was observed in the current study.