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Prevalence of Multi-Antibiotic Resistant Bacteria Isolated from Children with Urinary Tract Infection from Baghdad, Iraq

Salman Hamzah Abdulrahman|Alhameedawi Alaa kamil|Muhamad Sarah Mohammed Saeed Ghofran|Taha Zahraa
한국미생물·생명공학회 (The Korean Society For Microbiology And Biotechnology)|2022.03|한국미생물·생명공학회지 (Microbiology and Biotechnology Letters)|제50권 제1호|pp. 147-156|DOI 10.48022/mbl.2110.10011

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UTIMultidrug resistanceVitek 2 compactantibiotic susceptibility testing
주제분류생물학

초록

Urinary tract infections (UTIs) are one of the most common infections in different age groups, including children. Bacteria are the main etiological agents of UTIs. The aim of the present study was to isolate, identify, and determine the antibiotic susceptibility of bacteria isolated from children with UTIs from Baghdad, Iraq. Three hundred and two urine samples were collected from children aged 6 months to 12 years. The samples were cultured on blood agar and MacConkey agar. The selected colonies were subjected to biochemical tests and antibiotic susceptibility analysis using the Vitek® 2 Compact automated microbial identification system. In this sample, 299 bacteria were identified, of which, 267 were gram-negative bacteria, and 32 were gram-positive bacteria. Escherichia coli (56%) was the most commonly isolated gram-negative bacteria, followed by Pseudomonas aeruginosa (14%), Enterobacter spp. (10.48%), Klebsiella pneumoniae (9.36%), Proteus spp. (7.8%), Acinetobacter baumannii (1.5%), and Morganella morganii (0.37%). Enterococcus faecalis (62.5%) was the most commonly detected gram-positive bacteria, followed by Staphylococcus aureus (37.5%). E. coli and P. aeruginosa were the most antibiotic-resistant bacteria. Among the tested antibiotics, meropenem showed 100% sensitivity, followed by imipenem (97.4%), amikacin (91.8%), and tobramycin (83.5%). In contrast, the high frequencies of resistance were observed with cefixime (93.2%), cefotaxime (78.7%), and ceftriaxone/cefotaxime (71.2%). In conclusion, carbapenems and aminoglycosides are highly recommended for the empirical treatment of UTIs, while, Quinolones, penicillins, and cephalosporins are not suggested. Frequent antibiotics susceptibility testing are warranted to determine the resistance pattern of UTI bacteria.

Abstract

Urinary tract infections (UTIs) are one of the most common infections in different age groups, including children. Bacteria are the main etiological agents of UTIs. The aim of the present study was to isolate, identify, and determine the antibiotic susceptibility of bacteria isolated from children with UTIs from Baghdad, Iraq. Three hundred and two urine samples were collected from children aged 6 months to 12 years. The samples were cultured on blood agar and MacConkey agar. The selected colonies were subjected to biochemical tests and antibiotic susceptibility analysis using the Vitek® 2 Compact automated microbial identification system. In this sample, 299 bacteria were identified, of which, 267 were gram-negative bacteria, and 32 were gram-positive bacteria. Escherichia coli (56%) was the most commonly isolated gram-negative bacteria, followed by Pseudomonas aeruginosa (14%), Enterobacter spp. (10.48%), Klebsiella pneumoniae (9.36%), Proteus spp. (7.8%), Acinetobacter baumannii (1.5%), and Morganella morganii (0.37%). Enterococcus faecalis (62.5%) was the most commonly detected gram-positive bacteria, followed by Staphylococcus aureus (37.5%). E. coli and P. aeruginosa were the most antibiotic-resistant bacteria. Among the tested antibiotics, meropenem showed 100% sensitivity, followed by imipenem (97.4%), amikacin (91.8%), and tobramycin (83.5%). In contrast, the high frequencies of resistance were observed with cefixime (93.2%), cefotaxime (78.7%), and ceftriaxone/cefotaxime (71.2%). In conclusion, carbapenems and aminoglycosides are highly recommended for the empirical treatment of UTIs, while, Quinolones, penicillins, and cephalosporins are not suggested. Frequent antibiotics susceptibility testing are warranted to determine the resistance pattern of UTI bacteria.

참고문헌 (61)

  1. Sood A, "Incidence, admission rates, and economic burden of pediatric emergency department visits for urinary tract infection : Data from the nationwide emergency department sample, 2006 to 2011", J. Pediatr. Urol, 11, pp.246.e241~246.e248 (2015)
  2. Muhammad A, "Prevalence and antibiotic susceptibility pattern of uropathogens in outpatients at a tertiary care hospital", New Microbes New Infect, 36, pp.100716~ (2020)
  3. Kaufman J, "Urinary tract infections in children : an overview of diagnosis and management", BMJ Paediatr. Open, 3, pp.e000487~ (2019)
  4. Dibua UM, "Frequency, urinalysis and susceptibility profile of pathogens causing urinary tract infections in Enugu State, southeast Nigeria", Rev. Inst. Med. Trop. Sao Paulo, 56, pp.55~59 (2014)
  5. Tandogdu Z, "Global epidemiology of urinary tract infections", Curr. Opin. Infect. Dis, 29, pp.73~79 (2016)
  6. Pezeshki Najafabadi M, "Common microbial causes of significant bacteriuria and their antibiotic resistance pattern in the Isfahan province of Iran", J. Chemother, 30, pp.348~353 (2018)
  7. Montini G, "Febrile urinary tract infections in children", N. Engl. J. Med, 365, pp.239~250 (2011)
  8. Medina-Bombardó D, "Does clinical examination aid in the diagnosis of urinary tract infections in women? A systematic review and meta-analysis", BMC Fam. Pract, 12, pp.111~ (2011)
  9. Narain U, "Urinary tract infection in children with nephrotic syndrome", Pediatr. Infect. Dis. J, 37, pp.144~146 (2018)
  10. Sorkhi H, "Urinary tract infection in children with nephrotic syndrome : A systematic review and meta-analysis", Microb. Pathog, 137, pp.103718~ (2019)
  11. Faisal Anwer Jaber, "Determination of Semen Quality and Antibacterial Susceptibility Pattern of Bacteria Isolated from Semen of Iraqi Subjects", 한국미생물·생명공학회지, 49(4), pp.587~593 (2021), 한국미생물·생명공학회[DOI]
  12. Shirani K, "Prevalence and antibiotic resistance pattern of extended-spectrum beta-lactamaseproducing Escherichia coli in clinical specimens", J. Res. Med. Sci, 24, pp.103~ (2019)
  13. Salman HA, "Detection of multidrug-resistant Salmonella enterica subsp. enterica serovar Typhi isolated from Iraqi subjects", Vet. World, 14, pp.1922~1928 (2021)
  14. Dolk FCK, "Antibiotics in primary care in England: which antibiotics are prescribed and for which conditions?", J. Antimicrob. Chemother, 73, pp.ii2~ii10 (2018)
  15. Mishra MP, "Prevalence of multidrug resistant uropathogenic bacteria in pediatric patients of a tertiary care hospital in eastern India", J. Infect. Public Health, 9, pp.308~314 (2016)
  16. Lee DS, "Community-acquired urinary tract infection by Escherichia coli in the Era of antibiotic resistance", Biomed Res. Int, 2018, pp.7656752~ (2018)
  17. Sweileh WM, "Global research output in antimicrobial resistance among uropathogens : A bibliometric analysis(2002–2016)", J. Glob. Antimicrob. Resis, 13, pp.104~114 (2018)
  18. Mihankhah A, "Prevalence and antibiotic resistance pattern of bacteria isolated from urinary tract infections in Northern Iran", J. Res. Med. Sci, 22, pp.108~ (2017)
  19. Mortazavi SH, "Prevalence of class I and II integrons among MDR Enterobacter cloacae isolates obtained from clinical samples of children in Kermanshah, Iran", J. Clin. Diagnostic Res, 12, pp.DC13~DC16 (2018)
  20. Salman HA, "Determination of antibacterial activity and metabolite profile of Ruta graveolens against Streptococcus mutans and Streptococcus sobrinus", J. Llab. Phys, 10, pp.320~325 (2018)
  21. Salman HA, "Antibacterial activity of Annona squamosa L. and Annona reticulata L. against clinical isolates of mutans streptococci the causative agents of dental caries", Asian J. Pharm. Clin. Res, 8, pp.152~155 (2015)
  22. Al-Badr A, "Recurrent urinary tract infections management in women: A review", Sultan Qaboos Univ. Med. J, 13, pp.359~367 (2013)
  23. Tenney J, "Risk factors for aquiring multidrug-resistant organisms in urinary tract infections : A systematic literature review", Saudi Pharm. J, 26, pp.678~684 (2018)
  24. Erol B, "Changes in antimicrobial resistance and demographics of UTIs in pediatric patients in a single institution over a 6-year period", J. Pediatr. Urol, 14, pp.176.e171~176.e175 (2018)
  25. Demir M, "Uropathogens and antibiotic resistance in the community and hospital-induced urinary tract infected children", J. Glob. Antimicrob. Resist, 20, pp.68~73 (2020)
  26. Mitiku E, "Pediatric urinary tract infection as a cause of outpatient clinic visits in Southern Ethiopia : A cross sectional study", Ethiop J. Health Sci, 28, pp.187~196 (2018)
  27. Mirsoleymani SR, "Bacterial pathogens and antimicrobial resistance patterns in pediatric urinary tract infections : A fouryear surveillance study(2009-2012)", Int. J. Pediatr, 2014, pp.126142~ (2014)
  28. Merga Duffa Y, "Prevalence and antimicrobial susceptibility of bacterial uropathogens isolated from pediatric patients at yekatit 12 hospital medical college, Addis Ababa, Ethiopia", Int. J. Microbiol, 2018, pp.8492309~8492309 (2018)
  29. Chen Y-T, "Whole-genome sequencing and identification of Morganella morganii KT pathogenicity-related genes", BMC Genomics, 13(Suppl 7), pp.S4~ (2012)
  30. Al-Naqshbandi AA, "Prevalence and antimicrobial susceptibility of bacterial pathogens isolated from urine specimens received in rizgary hospital-Erbil", J. Infect. Public Health, 12, pp.330~336 (2019)
  31. Mohammed MA, "Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infection in Messalata Central Hospital, Libya", Asian Pac. J. Trop. Med, 9, pp.771~776 (2016)
  32. Megged O, "Staphylococcus aureus urinary tract infections in children are associated with urinary tract abnormalities and vesico-ureteral reflux", Pediatr. Nephrol, 29, pp.269~272 (2014)
  33. Bryce A, "Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care : systematic review and meta-analysis", BMJ, 352, pp.i939~ (2016)
  34. Bander B, "Antimicrobial susceptibility of microorganisms causing urinary tract infections in Saudi Arabia", J. Infect. Dev. Ctries, 12, pp.220~227 (2018)
  35. Khawcharoenporn T, "Urinary tract infections due to multidrug-resistant Enterobacteriaceae : Prevalence and risk factors in a Chicago emergency department", Emerg. Med. Int, 2013, pp.258517~ (2013)
  36. Zowawi HM, "The emerging threat of multidrug-resistant Gram-negative bacteria in urology", Nat. Rev. Urol, 12, pp.570~584 (2015)
  37. Goodlet KJ, "A Systematic review of single-dose aminoglycoside therapy for urinary tract infection : Is it time to resurrect an old strategy? Antimicrob", Agents Chemother, 63, pp.e02165-18~ (2019)
  38. Hamid M, "A deadly prescription : combination of methotrexate and trimethoprim-sulfamethoxazole", J. Community Hosp. Intern. Med. Perspect, 8, pp.149~151 (2018)
  39. Li X, "A 6-year study of complicated urinary tract infections in southern China : prevalence, antibiotic resistance, clinical and economic outcomes", Ther. Clin. Risk Manag, 13, pp.1479~1487 (2017)
  40. Kishore N, "Urinary tract infection in critically ill patients with diabetes mellitus : Spectrum of uropathogens and antimicrobial susceptibility pattern", Bali. J. Anaesthesiol, 4, pp.55~ (2020)
  41. Fanos V, "Cefixime in urinary tract infections with special reference to pediatrics: Overview", J. Chemother, 13, pp.112~117 (2001)
  42. Zegers SHJ, "The influence of antibiotic prophylaxis on bacterial resistance in urinary tract infections in children with spina bifida", BMC Infect. Dis, 17, pp.63~ (2017)
  43. Vranic SM, "Antimicrobial resistance of Escherichia coli strains isolated from urine at outpatient population : a single laboratory experience", Mater. Sociomed, 28, pp.121~124 (2016)
  44. Gitau W, "Antimicrobial susceptibility pattern of Staphylococcus aureus isolates from clinical specimens at Kenyatta National Hospital", BMC Res. Notes, 11, pp.226~ (2018)
  45. SharifiY, "Virulence and antimicrobial resistance in enterococci isolated from urinary tract infections", Adv. Pharm. Bull, 3, pp.197~201 (2013)
  46. Salman HA, "Identification and antibiogram profile of Streptococcus mutans and Streptococcus sobrinus from dental caries subjects", J. Appl. Pharm. Sci, 5, pp.54~57 (2015)
  47. Salman HA, "Detection and characterization of Streptococcus downei, a rare bacterial species of mutans streptococci from caries-active patients", Indian J. Dent. Res, 30, pp.579~582 (2019)
  48. Horner CS, "Surveillance of antibiotic susceptibility of Enterobacteriaceae isolated from urine samples collected from community patients in a large metropolitan area, 2010-2012", Epidemiol. Infect, 142, pp.399~403 (2014)
  49. Erb S, "Basic patient characteristics predict antimicrobial resistance in E. coli from urinary tract specimens: a retrospective cohort analysis of 5246 urine samples", Swiss Med. Wkly, 148, pp.w14660~ (2018)
  50. Guyomard-Rabenirina S, "Temporal trends and risks factors for antimicrobial resistant Enterobacteriaceae urinary isolates from outpatients in Guadeloupe", BMC Microbiol, 16, pp.121~ (2016)
  51. Pulcini C, "Antibiotic resistance of Enterobacteriaceae causing urinary tract infections in elderly patients living in the community and in the nursing home : a retrospective observational study", J. Antimicrob. Chemother, 74, pp.775~781 (2019)
  52. Sabir S, "Isolation and antibiotic susceptibility of E. coli from urinary tract infections in a tertiary care hospital", Pak J. Med. Sci, 30, pp.389~392 (2014)
  53. Sahu C, "Clinical and laboratory standards institute versus European committee for antimicrobial susceptibility testing guidelines for interpretation of carbapenem antimicrobial susceptibility results for Escherichia coli in urinary tract infection(UTI)", J. Lab. Physicians, 10, pp.289~293 (2018)
  54. MacFadden DR, "A Platform for monitoring regional antimicrobial resistance, using online data sources : Resistance Open", J. Infect. Dis, 214, pp.S393~S398 (2016)
  55. Reis AC, "Ciprofloxacin resistance pattern among bacteria isolated from patients with community-acquired urinary tract infection", Rev. Inst. Med. Trop. Sao Paulo, 58, pp.53~ (2016)
  56. Malekzadegan Y, "Prevalence of quinolone-resistant uropathogenic Escherichia coli in a tertiary care hospital in south Iran", Infect. Drug Resist, 12, pp.1683~1689 (2019)
  57. Bidell MR, "Fluoroquinolone and third-generation-cephalosporin resistance among hospitalized patients with urinary tract infections due to Escherichia coli : Do rates vary by hospital characteristics and geographic region?", Antimicrob. Agents Chemother, 60, pp.3170~3173 (2016)
  58. McQuiston Haslund J, "Different recommendations for empiric first-choice antibiotic treatment of uncomplicated urinary tract infections in Europe", Scand. J. Prim. Health Care, 31, pp.235~240 (2013)
  59. Muller AE, "Nitrofurantoin's efficacy and safety as prophylaxis for urinary tract infections : a systematic review of the literature and metaanalysis of controlled trials", Clin. Microbiol. Infect, 23, pp.355~362 (2017)
  60. Porreca A, "The clinical efficacy of nitrofurantoin for treating uncomplicated urinary tract infection in adults : A systematic review of randomized control trials", Urol. Int, 105, pp.531~540 (2021)
  61. Gardiner BJ, "Nitrofurantoin and fosfomycin for resistant urinary tract infections : old drugs for emerging problems", Aust. Prescr, 42, pp.14~19 (2019)

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