Published on 29.03.18 in Vol 4, No 1 (2018): EMPHNET Sixth Regional Conference
Preprints (earlier versions) of this paper are available at http://preprints.jmir.org/preprint/10539, first published Mar 29, 2018.
The Growing Antimicrobial Resistance of Urinary Tract Infections, Sana'a- Yemen, 2015
Background: Urinary tract infections (UTIs) remain a growing public health concern as it may lead to treatment failure and increasing morbidity and mortality. To optimize empirical antibiotic prescription, it is important for clinicians to have a working knowledge regarding UTIs etiological pathogens and its susceptibility patterns.
Objective: Determine the prevalence of UTIs, describe their responsible pathogens, and their antimicrobial resistance.
Methods: 2015 data on patients attended the Microbiology Department in National Centre for Public Health laboratories (NCPHL) for urine cultures was obtained. UTIs defined as =100,000 CFU/mL of an uropathogen in midstream urine culture. The causative pathogen was identified, and antibiotic resistance carried out by disc-diffusion method.
Results: Out of 2901 patients examined, 58% were females and half among 20-40 years age group. The prevalence of UTIs was 34% and more among females: Odds Ratio (OR): 1.8 (1.5-2.0) and elderly = 60 years (OR: 1.4 (1.1-1.8). Gram-negative bacteria constitute 73% of UTI and found to be highly resistance to Nalidixic acid (70%), Co-trimoxazole (64%), and Piperacillin (62%). Gram-positive bacteria that constitutes 27 % found to be highly resistant to Co-trimoxazole (81%), Norfloxacin (69%) and Amoxicillin (67%). E. coli was the most common pathogen (42%), followed by coagulase negative Staphylococci (10%) and Klebsiella (8%). While E. coli found to be resistant to Co-trimoxazole (66%) and Nalidixic acid (71%), Klebsiella was resistant to Co-trimoxazole (88%) and Nalidixic acid (64%), and Coagulase Negative Staphylococci to Co-trimoxazole (88%) and Amoxicillin (75%).
Conclusions: Findings highlight the doubling of UTIs prevalence and growing antibiotics resistance e.g. for Nalidixic acid from 54% to 70% since 2002. Results should guide antibiotic prescribing and developing strategies for controlling resistance. It also underlines the need to establish Antimicrobial Stewardship Program to reduce selection pressure and minimize resistance.
Edited by Y Khader; This is a non–peer-reviewed article. submitted 29.03.18; accepted 29.03.18; published 29.03.18
©Yasser Ghaleb, A Al Serouri, M Alamad, S Nasher, A Alsoumainy. Originally published in Iproceedings (http://www.iproc.org), 29.03.2018.
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