IPROC iproc Iproceedings 2369-6893 JMIR Publications Toronto, Canada v4i1e10539 10.2196/10539 Abstract Abstract The Growing Antimicrobial Resistance of Urinary Tract Infections, Sana'a- Yemen, 2015 Khader Yousef Ghaleb Yasser Al Serouri A Alamad M Nasher S Alsoumainy A Corresponding Author: Yasser Ghaleb Presenter: Email y.ghaleb@ymail.com Jan-Dec2018 29 03 2018 4 1 e10539 29 3 2018 29 3 2018 ©Yasser Ghaleb, A Al Serouri, M Alamad, S Nasher, A Alsoumainy. Originally published in Iproceedings (http://www.iproc.org), 29.03.2018. 2018

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 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.