Abstract

Urinary tract infection (UTI) is one of the most common bacterial infections worldwide. Inappropriate use of antibiotics in hospitalized UTI patients, and the consequent bacterial resistance, imposes high costs on health care settings. Therefore, this study aimed to investigate the prevalence of antimicrobial resistance in UTI patients hospitalized in the Ghaem University Hospital, Mashhad, Iran. Cross-sectional study with 28357 urine samples were collected from patients admitted in Ghaem University Hospital of Mashhad University Medical Sciences during the period from April 2017 to March 2020. For all samples, biochemical methods and the antimicrobial susceptibility testing was performed based on CLSI 2018. The collected data were analyzed using WHONET software. Out of 28357 urine samples, 3568 (12.58%) were confirmed as UTI. The prevalence of Gram negative and Gram positive bacteria was 77.42 and 22.58%, respectively.  Escherichia coli (43.97%) and Enterococcus faecalis (15.27%) were found as the most prevalent species among Gram negative and Gram positive bacteria. E. coli showed the lowest rate of resistance to meropenem (3.7%) and amikacin (6.9%) and highly resistance rate was found for ampicillin (83.3%) and piperacillin (82.4%). Meropenem, amikacin, linezolid, and nitrofurantoin showed better in vitro efficacy against urinary tract pathogens compared with other antibiotics. Therefore, despite universal guidelines, we recommend that empirical antibiotic selection should be done based on the local prevalence of bacterial organisms and antibiotic sensitivities.

Key words: Urinary tract infection, uropathogens, antibacterial susceptibility pattern, bacterial infections, Gram-negative bacteria, Escherichia coli.