Volume 12, Issue 1 (11-2022)
aumj 2022, 12(1): 35-41 |
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Razeghi Z, Goli H R, Salehian M, Gholami M. Evaluation of Antimicrobial Resistance Pattern in Escherichia coli Strains Isolated from Patients Referred to Teaching Hospitals of Mazandaran University of Medical Sciences. aumj 2022; 12 (1) :35-41
URL: http://aums.abzums.ac.ir/article-1-1621-en.html
URL: http://aums.abzums.ac.ir/article-1-1621-en.html
1- Medical Student, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
2- Assistant Professor, Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
3- MSc in Medical Microbiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
4- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
2- Assistant Professor, Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
3- MSc in Medical Microbiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
4- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
Abstract: (1138 Views)
Background: Urinary tract infections (UTIs) are among the most common infections in both outpatients and inpatients worldwide. Due to the widespread use of empirical antibiotic therapy, the resistance rate to bacteria causing UTIs has significantly increased. Therefore, the present study was designed to investigate the pattern of drug resistance in Escherichia coli strains isolated from patients with UTIs referred to the educational centers of Mazandaran University of Medical Sciences.
Methods: In this cross-sectional study, 100 urine samples completely randomly were taken from patients with UTI. Patient characteristics including age, gender, outpatient and/or inpatient were collected from patients' clinical records and laboratories data services. After confirmation of E. coli strains, antibiogram was performed by disk diffusion method according to Clinical Laboratory Standards Institute (CLSI) instructions.
Results: Out of 100 positive urine culture samples, the highest prevalence of E. coli causing UTI was seen in the female (83%) and outpatient (53%) groups. The age range of the patients was between 0 (6-month-old) and 95 years. The highest resistance was reported against ampicillin (66.6%) and the lowest resistance to imipenem (1%), followed by cefoxitin (1.2%) and gentamicin (1.7%), while resistance to amikacin and tobramycin was not found. Of 100 E. coli isolates, 44% were associated with multidrug resistance phenotype; 32 cases of which were women and 25 cases were for hospitalized patients.
Conclusions: Following the overuse and misuse of antibiotics, drug resistance is increasing over time. Due to high rates of resistance to ampicillin, cotrimoxazole and cephalosporins, especially cefazolin and cefotaxime, the use of these drugs in the treatment of UTIs will not be a good option. Our data show that carbapenems and aminoglycosides should be considered as an option for first-line treatment of hospitalized patients with UTIs, in the study area.
Methods: In this cross-sectional study, 100 urine samples completely randomly were taken from patients with UTI. Patient characteristics including age, gender, outpatient and/or inpatient were collected from patients' clinical records and laboratories data services. After confirmation of E. coli strains, antibiogram was performed by disk diffusion method according to Clinical Laboratory Standards Institute (CLSI) instructions.
Results: Out of 100 positive urine culture samples, the highest prevalence of E. coli causing UTI was seen in the female (83%) and outpatient (53%) groups. The age range of the patients was between 0 (6-month-old) and 95 years. The highest resistance was reported against ampicillin (66.6%) and the lowest resistance to imipenem (1%), followed by cefoxitin (1.2%) and gentamicin (1.7%), while resistance to amikacin and tobramycin was not found. Of 100 E. coli isolates, 44% were associated with multidrug resistance phenotype; 32 cases of which were women and 25 cases were for hospitalized patients.
Conclusions: Following the overuse and misuse of antibiotics, drug resistance is increasing over time. Due to high rates of resistance to ampicillin, cotrimoxazole and cephalosporins, especially cefazolin and cefotaxime, the use of these drugs in the treatment of UTIs will not be a good option. Our data show that carbapenems and aminoglycosides should be considered as an option for first-line treatment of hospitalized patients with UTIs, in the study area.
Type of Study: Research |
Subject:
Special
Received: 2022/10/24 | Accepted: 2022/11/01 | Published: 2022/11/01
Received: 2022/10/24 | Accepted: 2022/11/01 | Published: 2022/11/01
References
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2. Darvishi Ganji S, Jafarian F. Determination of the frequency of isolated bacteria and the pattern of antibiotic susceptibility and resistance of Escherichia coli isolated from urine samples in patients referred to 17 Shahrivar Hospital of Marzikla in Babol city. Zanko Journal of Medical Sciences. 2021;22(72):15-23.
3. Asadi Karam MR, Habibi M, Bouzari S. Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Mol Immunol. 2019;108:56-67. [DOI:10.1016/j.molimm.2019.02.007]
4. Albracht CD, Hreha TN, Hunstad DA. Sex effects in pyelonephritis. Pediatr Nephrol. 2021;36(3):507-15. [DOI:10.1007/s00467-020-04492-9]
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7. Esposito S, Maglietta G, Di Costanzo M, Ceccoli M, Vergine G, La Scola C, et al. Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy. Antibiotics. 2021;10(10):1207. [DOI:10.3390/antibiotics10101207]
8. Stephens GM, Akers S, Nguyen H, Woxland H. Evaluation and management of urinary tract infections in the school-aged child. Prim Care. 2015;42(1):33-41. [DOI:10.1016/j.pop.2014.09.007]
9. O'Brien VP, Hannan TJ, Nielsen HV, Hultgren SJ. Drug and Vaccine Development for the Treatment and Prevention of Urinary Tract Infections. Microbiol Spectr. 2016;4(1). [DOI:10.1128/microbiolspec.UTI-0013-2012]
10. Ghane M, Adham F. Frequency of TEM and PER Beta-Lactamase Genes in Urinary Isolates of Escherichia Coli Producing Extended-Spectrum Beta-Lactamases. Journal of Arak University of Medical Sciences. 2020;22(6):218-29. [DOI:10.32598/JAMS.22.6.2891.1]
11. Asadpour Rahimabadi K, Hashemitabar G, Mojtahedi A. Antibiotic-resistance Patterns in E.Coli Isolated from Patients with Urinary Tract Infection in Rasht. Jour of gums. 2016; 24 (96) :22-29
12. Mohammadi M, Ghasemi E, Mokhayeri H, Pournia Y, Boroun H. Antimicrobial resistance patterns of E. coli detected from hospitalized urine culture samples. Asian Journal of Biological Sciences. 2010;3(4):195-201. [DOI:10.3923/ajbs.2010.195.201]
13. Etebarzadeh Z, Oshaghi M, Amir Mozafari N. Evaluation of relationship between phylogenetic typing and antibiotic resistance of uropathogenic Escherichia coli. Journal of Microbial world. 2012;4(3&4):84-92.
14. Baghani Aval H, Ekrami Toroghi M, Haghighi F, Tabarraie Y. The study of common bacterial factors of urinary tract infections and determining their antibiotic resistance in hospitalized and out patients referred to the vase'ee hospital in Sabzevar in 2016. Journal of Sabzevar University of Medical Sciences. 2018 Nov 22;25(5):687-93.
15. Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in JNMC Hospital Aligarh, India. Annals of clinical microbiology and antimicrobials. 2007;6(1):1-7. [DOI:10.1186/1476-0711-6-4]
16. Das R, Perrelli E, Towle V, Van Ness PH, Juthani-Mehta M. Antimicrobial susceptibility of bacteria isolated from urine samples obtained from nursing home residents. Infection Control & Hospital Epidemiology. 2009;30(11):1116-9. [DOI:10.1086/647981]
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18. Farajnia S, Alikhani MY, Ghotaslou R, Naghili B, Nakhlband A. Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran. International Journal of Infectious Diseases. 2009;13(2):140-4. [DOI:10.1016/j.ijid.2008.04.014]
19. Investigation of antibiotic susceptibility pattern of E.coli isolated from urinary culture related to patients in the west of the Mazandaran province, during from September 2010 to September 2011.. Experimental animal Biology, 2013; (): 12-24.
20. Kurutepe S, Surucuoglu S, Sezgin C, Gazi H, Gulay M, Ozbakkaloglu B. Increasing antimicrobial resistance in Escherichia coli isolates from community-acquired urinary tract infections during 1998-2003 in Manisa, Turkey. Japanese journal of infectious diseases. 2005;58(3):159.
21. Abbasi Valdani N. Frequency of study and pattern of microbial resistance of common bacteria isolated from urinary tract infections in patients of different wards of Afzalipour Hospital in Kerman in 1397.
22. Darvishi Ganji S, Jafarian F. Determination of the frequency of isolated bacteria and the pattern of antibiotic susceptibility and resistance of Escherichia coli isolated from urine samples in patients referred to 17 Shahrivar Hospital of Marzikla in Babol city. Zanko Journal of Medical Sciences. 2021;22(72):15-23.
23. Asadi Karam MR, Habibi M, Bouzari S. Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Mol Immunol. 2019;108:56-67. [DOI:10.1016/j.molimm.2019.02.007]
24. Albracht CD, Hreha TN, Hunstad DA. Sex effects in pyelonephritis. Pediatr Nephrol. 2021;36(3):507-15. [DOI:10.1007/s00467-020-04492-9]
25. Tandan M, Duane S, Cormican M, Murphy AW, Vellinga A. Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice. Antibiotics (Basel). 2016;5(3). [DOI:10.3390/antibiotics5030031]
26. Vasudevan R. Urinary tract infection: an overview of the infection and the associated risk factors. J Microbiol Exp. 2014;1(2):00008. [DOI:10.15406/jmen.2014.01.00008]
27. Esposito S, Maglietta G, Di Costanzo M, Ceccoli M, Vergine G, La Scola C, et al. Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy. Antibiotics. 2021;10(10):1207. [DOI:10.3390/antibiotics10101207]
28. Stephens GM, Akers S, Nguyen H, Woxland H. Evaluation and management of urinary tract infections in the school-aged child. Prim Care. 2015;42(1):33-41. [DOI:10.1016/j.pop.2014.09.007]
29. O'Brien VP, Hannan TJ, Nielsen HV, Hultgren SJ. Drug and Vaccine Development for the Treatment and Prevention of Urinary Tract Infections. Microbiol Spectr. 2016;4(1). [DOI:10.1128/microbiolspec.UTI-0013-2012]
30. Ghane M, Adham F. Frequency of TEM and PER Beta-Lactamase Genes in Urinary Isolates of Escherichia Coli Producing Extended-Spectrum Beta-Lactamases. Journal of Arak University of Medical Sciences. 2020;22(6):218-29. [DOI:10.32598/JAMS.22.6.2891.1]
31. Asadpour Rahimabadi K, Hashemitabar G, Mojtahedi A. Antibiotic-resistance Patterns in E.Coli Isolated from Patients with Urinary Tract Infection in Rasht. Jour of gums. 2016; 24 (96) :22-29
32. Mohammadi M, Ghasemi E, Mokhayeri H, Pournia Y, Boroun H. Antimicrobial resistance patterns of E. coli detected from hospitalized urine culture samples. Asian Journal of Biological Sciences. 2010;3(4):195-201. [DOI:10.3923/ajbs.2010.195.201]
33. Etebarzadeh Z, Oshaghi M, Amir Mozafari N. Evaluation of relationship between phylogenetic typing and antibiotic resistance of uropathogenic Escherichia coli. Journal of Microbial world. 2012;4(3&4):84-92.
34. Baghani Aval H, Ekrami Toroghi M, Haghighi F, Tabarraie Y. The study of common bacterial factors of urinary tract infections and determining their antibiotic resistance in hospitalized and out patients referred to the vase'ee hospital in Sabzevar in 2016. Journal of Sabzevar University of Medical Sciences. 2018 Nov 22;25(5):687-93.
35. Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in JNMC Hospital Aligarh, India. Annals of clinical microbiology and antimicrobials. 2007;6(1):1-7. [DOI:10.1186/1476-0711-6-4]
36. Das R, Perrelli E, Towle V, Van Ness PH, Juthani-Mehta M. Antimicrobial susceptibility of bacteria isolated from urine samples obtained from nursing home residents. Infection Control & Hospital Epidemiology. 2009;30(11):1116-9. [DOI:10.1086/647981]
37. Linhares I, Raposo T, Rodrigues A, Almeida A. Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a ten-year surveillance study (2000-2009). BMC infectious diseases. 2013;13(1):1-14. [DOI:10.1186/1471-2334-13-19]
38. Farajnia S, Alikhani MY, Ghotaslou R, Naghili B, Nakhlband A. Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran. International Journal of Infectious Diseases. 2009;13(2):140-4. [DOI:10.1016/j.ijid.2008.04.014]
39. Investigation of antibiotic susceptibility pattern of E.coli isolated from urinary culture related to patients in the west of the Mazandaran province, during from September 2010 to September 2011.. Experimental animal Biology, 2013; (): 12-24.
40. Kurutepe S, Surucuoglu S, Sezgin C, Gazi H, Gulay M, Ozbakkaloglu B. Increasing antimicrobial resistance in Escherichia coli isolates from community-acquired urinary tract infections during 1998-2003 in Manisa, Turkey. Japanese journal of infectious diseases. 2005;58(3):159.
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