Abstract

ABSTRACT
Background: The high incidence of multi-resistant uropathogens is of great epidemiological significance because the etiological agents of urinary tract infection are quite capable of spreading through susceptible population.
Objective: to study the extent of antimicrobial resistance of uropathogens in Basrah.
Patients & Methods: A cross-sectional study involving 789 patients, 610 patients attending outpatient clinics in three hospitals in Basrah city and 179 admitted patients in Al-Sader Teaching Hospital, was carried out. Patients included in the study were those with symptoms suggestive of urinary tract infection and were not on antibiotics for at least one week. The study was conducted during the period between January 2003 and March 2004. For each patient a general urine examination and urine culture were done. Identification of the isolated bacteria was performed according to a standard method and antimicrobial susceptibility test was performed using the diffusion disk method.
Results: Out of 610 outpatients included in the study, 443(72.6%) had positive culture, 128(61%) of males and 315 (78.8%) of females. E.coli was the commonest organism, isolated from 205 urine samples representing 43.7% of the total isolates, followed by other gram negative bacteria: Klebsiella sp., Proteus sp., and Pseudomonas aeruginosa. Gram positive cocci represented 7.7% & 3.6%.for CoPS and CoNS respectively. On the other hand, Klebsiella sp were the most commonly isolated bacterial uropathogens from inpatients, they represented 47.7% of the total isolates. Sensitivity rates to all chemotherapeutic agents among uropathogens isolated from hospital acquired urinary tract infections (the inpatient group) were lower than that of sensitivity rates of uropathogens isolated from the community acquired urinary tract infection. The overall sensitivity rates of isolates recovered from patients with hospital acquired urinary tract infection for norfloxacin, and ciprofloxacin were 59.3%, and 39.5%, while the sensitivity rates of the isolates reported from community acquired urinary tract infection for the same agents were 83.6%, and 39.5% respectively.
Conclusions: Both hospital and community acquired uropathogens showed resistance to all classes of antimicrobial agents.