Identification of Common Uropathogens in Patients with Culture-Confirmed Urinary Tract Infection
Keywords:
Urinary Tract Infection, Diagnostics, Antibiotics, Nephrology, uropathogens, antimicrobial resistance, multidrug resistance, Klebsiella pneumoniae, antimicrobial susceptibilityAbstract
Background: Urinary tract infections (UTIs) are a major burden on the health care system and are the most common reason for antibiotic prescriptions in health care. The objectives of this study were to identify the spectrum of bacterial pathogens associated with culture-proven UTI and their antimicrobial resistance patterns and associated clinical parameters. Methodology: This cross-sectional study (n=90) included a structured data collection form that was used to gather the demographic and clinical information. The urine samples were analyzed in the usual way for bacteriological identification and antimicrobial susceptibility testing. Frequencies of the bacterial isolates, antimicrobial susceptibility patterns, multidrug-resistant (MDR) organisms and factors associated with the MDR infections were determined (SPSS 26.0, P-value<0.05). Results: The mean age of the participants was 43.8 ± 16.2 years, and 61.1% were women. Klebsiella pneumoniae (27.8%), Proteus mirabilis (20.0%) and Staphylococcus saprophyticus (16.7%) were the most common uropathogens found. There were significant differences in the distribution of pathogens between age groups and between gender (p < 0.05). Antimicrobial susceptibility testing revealed that the highest sensitivity was to imipenem (88.9%), amikacin (81.1%) and nitrofurantoin (76.7%), while high resistance rates were seen in ceftriaxone (61.1%) and ciprofloxacin (57.8%). Twenty-three percent of isolates were predicted to produce extended-spectrum beta-lactamase and 37.8% were multidrug resistant. Diagnostic logistic regression analysis showed that diabetes mellitus (p = 0.024; OR = 2.81) and recurrent UTI (p = 0.007; OR = 3.47) were the significant factors. Conclusion: Klebsiella pneumoniae is the most frequent pathogen of culture-confirmed UTIs, and Gram-negative organisms continue to be the major cause of UTIs.
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