Volume 18, Issue 1 (Jan-Feb 2024)                   mljgoums 2024, 18(1): 23-26 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Shirdel Abdolmaleki A, Rafati Zomorodi A, Motamedifar M, Malekzadegan Y. Antimicrobial susceptibility patterns in Escherichia coli isolates from Hospital-acquired urinary tract infections. mljgoums 2024; 18 (1) :23-26
URL: http://mlj.goums.ac.ir/article-1-1521-en.html
1- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
2- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran , motamedm@sums.ac.ir
3- Department of Microbiology, Saveh University of Medical Sciences, Saveh, Iran
Abstract:   (457 Views)
Background: Urinary tract infection (UTI) is one of the most common bacterial infections of all ages and sexes. Escherichia coli is reported as the most common predominant pathogen. Urinary tract infection treatment leads to abundant antibiotic application in hospitals and communities, continuously developing multidrug resistance (MDR). This study aimed to determine the sensitivity and resistance pattern to common antibiotics among E. coli isolates from patients with UTIs at Nemazee Hospital in Shiraz.
Methods: This retrospective cross-sectional survey studied 1910 positive urine samples with E. coli bacteria from patients referred to Nemazee Hospital from 2018 to 2019. Antimicrobial susceptibility testing was performed on 12 commonly used antibiotics for UTIs.
Results: A total of 1910 E. coli isolates were gathered during these 2 years. The most highlighted resistance was observed against quinolones and cephalosporins at 86.9% and 89.7%, respectively. Cephalexin (87.9%) and nalidixic acid (86.1%) have shown the lowest activity against E. coli isolates. Also, the highest susceptibility was determined for amikacin (88.3%), nitrofurantoin (76.8%), and gentamicin (70.6%). In addition, 1624 (85%) isolates were MDR.
Conclusion: In conclusion, resistance to antibiotics (such as ciprofloxacin, norfloxacin, tetracycline, cefotaxime, and nitrofurantoin) is increasing. Therefore, it is vital to follow an appropriate antimicrobial stewardship program.

 
Full-Text [PDF 556 kb]   (110 Downloads) |   |   Full-Text (HTML)  (46 Views)  
Research Article: Research Article | Subject: bacteriology
Received: 2022/05/22 | Accepted: 2023/05/22 | Published: 2024/01/21 | ePublished: 2024/01/21

References
1. Izadi N, Eshrati B, Etemad K, Mehrabi Y, Hashemi-Nazari S-S. Rate of the incidence of hospital-acquired infections in Iran based on the data of the national nosocomial infections surveillance. New Microbes New Infect. 2020;38:100768. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Nouri F, Karami P, Zarei O, Kosari F, Alikhani MY, Zandkarimi E, et al. Prevalence of common nosocomial infections and evaluation of antibiotic resistance patterns in patients with secondary infections in Hamadan, Iran. Infect Drug Resist. 2020;13:2365-74. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Faezi Ghasemi M, Dibadji SN. Prevalence of blaoxa-1 and blashv Genes in E. coli Isolates from Hospitalized Patients in Rasht. Med Laborator J. 2016;10(5):65-70. [View at Publisher] [DOI] [Google Scholar]
4. Dashti AS, Kadivar MR, Tabatabai A, Zand F, Salami S, Ezadpanah S, et al. Prevalence of Healthcare-Associated Infections in Pediatric Wards of Nemazee Teaching Hospital in Shiraz: A Comparison with the Whole Hospital. Arch Pediatr Infect Dis. 2019;7(1). [View at Publisher] [DOI] [Google scholar]
5. Hassanzadeh P, Motamedifar M, Hadi N. Prevalent bacterial infections in intensive care units of Shiraz University of medical sciences teaching hospitals, Shiraz, Iran. Jpn J Infect Dis. 2009;62(4):249-53. [View at Publisher] [DOI] [PMID] [Google scholar]
6. Wolfensberger A, Kuster SP, Marchesi M, Zbinden R, Hombach M. The effect of varying multidrug-resistence (MDR) definitions on rates of MDR gram-negative rods. Antimicrob Resist Infect Control. 2019;8(1):1-9. [View at Publisher] [DOI] [PMID] [Google scholar]
7. Gonzalez M, Razzano D, Ebid A, Schubert FD. Clinical and Antibiotic Management of Urinary Tract Infections Pre-and Postimplementation of the CLINITEK AUWi System From Siemens to Screen Out Negative Urine Samples Submitted for Culture: A Retrospective Cohort Study. Lab Med. 2018;49(1):18-24. [View at Publisher] [DOI] [PMID] [Google scholar]
8. Lopez AMCO, Tan CJL, Yabon AS, Masbang AN. Symptomatic treatment (using NSAIDS) versus antibiotics in uncomplicated lower urinary tract infection: a meta-analysis and systematic review of randomized controlled trials. BMC Infecti Dis. 2021;21(1):619. [View at Publisher] [DOI] [PMID] [Google scholar]
9. Stapleton AE, Wagenlehner FM, Mulgirigama A, Twynholm M. E coli Resistance to Fluoroquinolones in Community-Acquired Uncomplicated Urinary Tract Infection In Women: A Systematic Review. Antimicrob Agents Chemother. 2020;64(10):e00862-20. [View at Publisher] [DOI] [PMID] [Google scholar]
10. Rastogi R, Martinez KA, Gupta N, Rood M, Rothberg MB. Management of urinary tract infections in direct to consumer telemedicine. J Gen Intern Med. 2020;35(3):643-8. [View at Publisher] [DOI] [PMID] [Google scholar]
11. Vieira DC, Lima WG, de Paiva MC. Plasmid-mediated quinolone resistance (PMQR) among Enterobacteriales in Latin America: a systematic review. Mol Biol Rep. 2020;47(2):1471-83. [View at Publisher] [DOI] [PMID] [Google scholar]
12. Taha SA, Omar HH. Characterization of plasmid-mediated qnrA and qnrB genes among Enterobacteriaceae strains: quinolone resistance and ESBL production in Ismailia, Egypt. Egypt J Med Hum Genet. 2019;20(1):1-7. [View at Publisher] [DOI] [Google scholar]
13. Aflakian F, Rad M, Salimizand H, Nemati A, Zomorodi AR. Detection of virulence genes and determination of the antimicrobial susceptibility of Escherichia coli isolates with mastitis in Mashhad, Iran-a short communication. Veterinarski arhiv. 2022;92(4):525-30. [View at Publisher] [DOI] [Google scholar]
14. CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2020. [View at Publisher] [Google scholar]
15. Lee DS, Lee S-J, Choe HS. Community-acquired urinary tract infection by Escherichia coli in the era of antibiotic resistance. BioMed Res Int. 2018;2018:7656752. [View at Publisher] [DOI] [PMID] [Google scholar]
16. Sako A, Yasunaga H, Matsui H, Fushimi K, Yanai H, Gu Y, et al. Hospitalization for urinary tract infections in Japan, 2010-2015: a retrospective study using a national inpatient database. BMC Infect Dis. 2021;21(1):1048. [View at Publisher] [DOI] [PMID] [Google scholar]
17. Asma B, Vicky L, Stephanie D, Yves D, Amy H, Sylvie D. Standardised high dose versus low dose cranberry Proanthocyanidin extracts for the prevention of recurrent urinary tract infection in healthy women [PACCANN]: a double blind randomised controlled trial protocol. BMC Urol. 2018;18(1):29. [View at Publisher] [DOI] [PMID] [Google scholar]
18. Neupane S, Pant ND, Khatiwada S, Chaudhary R, Banjara MR. Correlation between biofilm formation and resistance toward different commonly used antibiotics along with extended spectrum beta lactamase production in uropathogenic Escherichia coli isolated from the patients suspected of urinary tract infections visiting Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. Antimicrob Resist Infect Control. 2016;5(1):5. [View at Publisher] [DOI] [PMID] [Google scholar]
19. Hossain A, Hossain SA, Fatema AN, Wahab A, Alam MM, Islam MN, et al. Age and gender-specific antibiotic resistance patterns among Bangladeshi patients with urinary tract infection caused by Escherichia coli. Heliyon. 2020;6(6):e04161. [View at Publisher] [DOI] [PMID] [Google scholar]
20. Kim YJ, Lee J-M, Cho J, Lee J. Change in the annual antibiotic susceptibility of Escherichia coli in community-onset urinary tract infection between 2008 and 2017 in a tertiary care hospital in Korea. J Korean Med Sci. 2019;34(34):e228. [View at Publisher] [DOI] [PMID] [Google scholar]
21. Shakya P, Shrestha D, Maharjan E, Sharma VK, Paudyal R. ESBL production among E. coli and Klebsiella spp. causing urinary tract infection: a hospital based study. Open Microbiol J. 2017;11:23-30. [View at Publisher] [DOI] [PMID] [Google scholar]
22. Pouladfar G, Basiratnia M, Anvarinejad M, Abbasi P, Amirmoezi F, Zare S. The antibiotic susceptibility patterns of uropathogens among children with urinary tract infection in Shiraz. Medicine (Baltimore). 2017;96(37):e7834. [View at Publisher] [DOI] [PMID] [Google scholar]
23. Park K-H, Oh WS, Kim ES, Park SW, Hur J-A, Kim YK, et al. Factors associated with ciprofloxacin-and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department. Int J Infect Dis. 2014;23:8-13. [View at Publisher] [DOI] [PMID] [Google Scholar]
24. Rossignol L, Vaux S, Maugat S, Blake A, Barlier R, Heym B, et al. Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study. Infection. 2017;45(1):33-40. [View at Publisher] [DOI] [PMID] [Google Scholar]
25. Komijani M, Bouzari M, Rahimi F. Detection of TEM, SHV and CTX-M antibiotic resistance genes in Escherichia coli isolates from infected wounds. Medical Laboratory Journal. 2017;11(2):30-5. [View at Publisher] [DOI] [Google Scholar]
26. Giske C. Contemporary resistance trends and mechanisms for the old antibiotics colistin, temocillin, fosfomycin, mecillinam and nitrofurantoin. Clin Microbiol Infect. 2015;21(10):899-905. [View at Publisher] [DOI] [PMID] [Google Scholar]
27. Critchley IA, Cotroneo N, Pucci MJ, Mendes R. The burden of antimicrobial resistance among urinary tract isolates of Escherichia coli in the United States in 2017. PLoS One. 2019;14(12):e0220265. [View at Publisher] [DOI] [PMID] [Google scholar]
28. Basu S, Mukherjee M. Incidence and risk of co-transmission of plasmid-mediated quinolone resistance and extended-spectrum β-lactamase genes in fluoroquinolone-resistant uropathogenic Escherichia coli: a first study from Kolkata, India. J Glob Antimicrob Resist. 2018;14:217-23. [View at Publisher] [DOI] [PMID] [Google Scholar]
29. Esmaeel NE, Gerges MA, Hosny TA, Ali AR, Gebriel MG. Detection of chromosomal and plasmid-mediated quinolone resistance among Escherichia coli Isolated from urinary tract infection cases; Zagazig University Hospitals, Egypt. Infect Drug Resist. 2020;13:413-21. [View at Publisher] [DOI] [PMID] [Google scholar]
30. Mirzaii M, Jamshidi S, Zamanzadeh M, Marashifard M, Hosseini SAAM, Haeili M, et al. Determination of gyrA and parC mutations and prevalence of plasmid-mediated quinolone resistance genes in Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infection in Iran. J Glob Antimicrob Resist. 2018;13:197-200. [View at Publisher] [DOI] [PMID] [Google Scholar]
31. Norouzian H, Shahrokhi N, Sabeti S, Bouzari S, Pooya M. Evaluation of Quinolone Resistance in Escherichia coli Isolates Recovered from Urine and Feces of Patients with Acute or Recurrent Urinary Tract Infection. J Med Microbiol Infect Dis. 2019;7(4):120-6. [View at Publisher] [DOI] [Google Scholar]
32. Neamati F, Firoozeh F, Saffari M, Zibaei M. Virulence genes and antimicrobial resistance pattern in uropathogenic Escherichia coli isolated from hospitalized patients in Kashan, Iran. Jundishapur J Microbiol. 2015;8(2):e17514. [View at Publisher] [DOI] [PMID] [Google scholar]
33. Khoramrooz SS, Sharifi A, Yazdanpanah M, Hosseini SAAM, Emaneini M, Gharibpour F, et al. High frequency of class 1 integrons in Escherichia coli isolated from patients with urinary tract infections in Yasuj, Iran. Iran Red Crescent Med J. 2016;18(1):e26399. [View at Publisher] [DOI] [PMID] [Google scholar]
34. Mamani M, Nobari N, Alikhani MY, Poorolajal J. Antibacterial susceptibility of Escherichia coli among outpatients with community-acquired urinary tract infection in Hamadan, Iran. J Glob Antimicrob Resist. 2015;3(1):40-3. [View at Publisher] [DOI] [PMID] [Google Scholar]
35. Naziri Z, Derakhshandeh A, Borchaloee AS, Poormaleknia M, Azimzadeh N. Treatment failure in urinary tract infections: a warning witness for virulent multi-drug resistant ESBL-producing Escherichia coli. Infect Drug Resist. 2020;13:1839-50. [View at Publisher] [DOI] [PMID] [Google scholar]
36. Ramírez-Castillo FY, Moreno-Flores AC, Avelar-González FJ, Márquez-Díaz F, Harel J, Guerrero-Barrera AL. An evaluation of multidrug-resistant Escherichia coli isolates in urinary tract infections from Aguascalientes, Mexico: cross-sectional study. Ann Clin Microbiol Antimicrob. 2018;17(1):34. [View at Publisher] [DOI] [PMID] [Google scholar]
37. Sharma N, Gupta A, Walia G, Bakhshi R. Pattern of antimicrobial resistance of Escherichia coli isolates from urinary tract infection patients: A three year retrospective study. J Appl Pharm Sci. 2016;6(1):062-5. [View at Publisher] [DOI] [Google Scholar]
38. Pandit R, Awal B, Shrestha SS, Joshi G, Rijal BP, Parajuli NP. Extended-spectrum β-lactamase (ESBL) genotypes among multidrug-resistant uropathogenic Escherichia coli clinical isolates from a teaching hospital of Nepal. Interdiscip Perspect Infect Dis. 2020;2020:6525826. [View at Publisher] [DOI] [PMID] [Google scholar]
39. Masoud SM, El-Baky A, Mahmoud R, Aly SA, Ibrahem RA. Co-existence of certain ESBLs, MBLs and plasmid mediated quinolone resistance genes among MDR E. coli isolated from different clinical specimens in Egypt. Antibiotics. 2021;10(7):835. [View at Publisher] [DOI] [PMID] [Google scholar]
40. Chowdhury N, Suhani S, Purkaystha A, Begum MK, Raihan T, Alam MJ, et al. Identification of AcrAB-TolC efflux pump genes and detection of mutation in efflux repressor AcrR from omeprazole responsive multidrug-resistant Escherichia coli isolates causing urinary tract infections. Microbiol Insights. 2019;12:1178636119889629. [View at Publisher] [DOI] [PMID] [Google scholar]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2007 All Rights Reserved | Medical Laboratory Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.