Antimicrobial resistance of E. coli and K. pneumoniae isolated from patients with urinary tract infections
DOI:
https://doi.org/10.52556/2587-3873.2023.4(97).25Keywords:
E. coli, K. pneumoniae, antimicrobial resistance, urinary tract infectionAbstract
Urinary tract infections (UTIs) and antimicrobial resistance are a global health problems and public health threats. UTIs are most commonly caused by Gram-negative microorganisms, such as E. coli, K. pneumonia, and P. mirabilis. The aim of this study is to evaluate the antimicrobial resistance of E. coli and K. pneumoniae strains isolated from patients with urinary tract infections. Materials and methods. The study batch included 2750 strains of Escherichia coli and 867 strains of Klebsiella pneumoniae isolated from UTI. Antimicrobial resistance of clinical isolates was determined by the diffusimetric method and the VITEK 2 Compact automated system (bioMerieux). Results. The results of the study demonstrated that both E. coli and K. pneumoniae strains isolated from urine cultures showed a high degree of resistance to antimicrobial preparations. K. pneumonia showed much higher levels of resistance, a big difference being observed for carbapenems, where E. coli showed resistance in 0.8% of cases, and K. pneumoniae – 26.4% of cases. The most common resistance mechanism (67.4%) was the production of extended-spectrum beta-lactamases, mostly detected in E. coli strains. The K. pneumoniae strains most frequently produced carbapenemases, especially OXA-48 (30.5%). Conclusions. Uropathogenic strains of E. coli and K. pneumonia have been shown to be resistant to most classes of antimicrobials used in the treatment of UTI, and these findings may be useful for clinicians in making treatment decisions for these infections.
References
1. Bader M., Loeb M., Leto D., Brooks A. Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents. Postgrad Med. 2020; 132(3):234-250. https://doi.org/10.1080/00325481.2019.1680052
2. Flores-Mireles A., Walker J., Caparon M., Hultgren S. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269. https://doi.org/10.1038/nrmicro3432
3. Huang L., Huang C., Yan Y., Sun L., Li H. Urinary Tract Infection Etiological Profiles and Antibiotic Resistance Patterns Varied Among Different Age Categories: A Retrospective Study From a Tertiary General Hospital During a 12-Year Period. Front Microbiol. 2022 Jan 27;12:813145. https://doi.org/10.3389/fmicb.2021.813145
4. Pezeshki Najafabadi M., Dagoohian A., Rajaie S., Zarkesh-Esfahani S., Edalati M. Common microbial causes of significant bacteriuria and their antibiotic resistance pattern in the Isfahan Province of Iran. J Chemother. 2018 Oct-Dec;30(6-8):348-353. https://doi.org/10.1080/1120009X.2018.1525120
5. Behzadi P., Urban E., Matuz M., Benko R., Gajdacs M. (2021). The Role of Gram-Negative Bacteria in Urinary Tract Infections: current Concepts and Therapeutic Options. Adv. Exp. Med. Biol. 2021; 1323, 35-69. https://doi.org/10.1007/5584_2020_566
6. Majumder M., Mahadi A., Ahmed T. et al. Antibiotic resistance pattern of microorganisms causing urinary tract infection: a 10-year comparative analysis in a tertiary care hospital of Bangladesh. Antimicrob Resist Infect Control. 2022; 11, 156. https://doi.org/10.1186/s13756-022-01197-6
7. Mortazavi-Tabatabaei S., Ghaderkhani J., Nazari A., Sayehmiri K., Sayehmiri F., Pakzad I. Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis. Int J Prev Med. 2019; 9;10:169. https://doi.org/10.4103/ijpvm.IJPVM_419_17
8. Burduniuc O., Ceban E., Bălan G., Plăcintă, Gh., Vişnevsch, A., Sofronie O., Bivol M. Ghidul "Asigurarea calității în diagnosticul microbiologic al infecțiilor tractului urinar". ÎS F.E.-P. "Tipografia Centrală", Chişinău 2021, 64 p. ISBN 978-9975-3415-9-2.
9. EUCAST. Guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance. Version 2.01 July 2017. https://aurosan.de/images/mediathek/servicematerial/EUCAST_detection_of_resistance_mechanisms.pdf.
10. Kanj S., Bassetti M., Kiratisin P., Rodrigues C., Villegas M., Yu Y., van Duin D. Clinical data from studies involving novel antibiotics to treat multidrug-resistant Gram-negative bacterial infections. Int J Antimicrob Agents. 2022; 60(3):106633. https://doi.org/10.1016/j.ijantimicag.2022.106633
11. Belete M., Saravanan M. A Systematic Review on Drug Resistant Urinary Tract Infection Among Pregnant Women in Developing Countries in Africa and Asia; 2005-2016. Infect. Drug Resist. 2020; 13, 1465-1477. https://doi.org/10.2147/IDR.S250654
12. Muhammad A., Khan S., Ali N., Rehman M., Ali I. Prevalence and antibiotic susceptibility pattern of uropathogens in outpatients at a tertiary care hospital. New Microbes New Infect. 2020; 36:100716. https://doi.org/10.1016/j.nmni.2020.100716
13. Kot B. Antibiotic Resistance Among Uropathogenic Escherichia coli. Pol J Microbiol. 2019;68(4):403-415. https://doi.org/10.33073/pjm-2019-048
14. Albaramki J., Abdelghani T., Dalaeen A. et al. Urinary tract infection caused by extended-spectrum β-lactamase-producing bacteria: Risk factors and antibiotic resistance. Pediatr Int. 2019; 61(11):1127-1132. https://doi.org/10.1111/ped.13911
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