TITLE:
Urinary Tract Infections in a Tunisian Orthopedic Institute: Major Strain Microbiological Profile
AUTHORS:
Hajer Kilani, Salma Kaoual, Fatma Kaabi, Sophia Bouhalila Besbes
KEYWORDS:
Gram-Negative, UTI, Hospital, Community, Bacteria
JOURNAL NAME:
Advances in Bioscience and Biotechnology,
Vol.14 No.3,
March
8,
2023
ABSTRACT: Background: Urinary Tract Infection (UTI)
detected in the hospital and in the community
is one of the most common reasons for consultation in everyday
practice; it represents a major source of antibiotic consumption. This study’s objectives were to outline the
microbiological profile of Tunisian patients with UTI and assess antibiotic
resistance over the course of three years at the Orthopedic Institute. Methods: All strains identified in urine samples between January 1st, 2019, and December
31st, 2021, were included. Standard laboratory procedures were used to
identify the bacterium. The Microscan Walkway 40 Plus was used to do
biochemical assays and antibiotic susceptibility testing. The EUCAST criteria
were used to interpret the findings. Results: A total of 1313 strains were isolated. The bacteriological
study showed the predominance of
enterobacteria (96.8%), especially E. coli (52.2%) and K. pneumoniae (19.3%). Overall resistance rates to
antimicrobial agents were as follows:
for hospital, E. coli strains were in descending order amoxicillin (73.05%),
trimeth/sulfamethoxazole (46.9%), ofloxacin (40.3%), amoxicillin/clavulanic acid (35.05%) and gentamicin (20.5%). Our results
showed low resistance to fosfomycin
for E. coli 2.6% in hospitals while ≥12.1% for K. pneumoniae. Amikacin resistance remains medium-low for E. coli being ≥20% and 10% for K. pneumonia. Nitrofuran resistance has affected
1.06% of E. coli strains in hospital
settings and 21.5% of K. pneumoniae. Extended Spectrum Beta-Lactamases
(ESBLs) production was present in a number
of enterobacteria (19.3% of K. pneumoniae and 14.4% of E. coli). Conclusion: The prevalence of E. coli and K. pneumoniae producers ESBLs in UTI is
increasing. Rigorous surveillance of resistance rate is necessary to determine appropriate empirical
treatment and limit the spread of multiresistant strains.