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Investigating the antibiotic resistance pattern of uropathogenic Escherichia coli isolated from urinary tract infections of outpatients based on gender and age
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Yasin Kalantari    , Azad Khaledi , Maede Najafizade , Gholam Abbas Mousavi , Iman Saffari |
| , azadkh99@gmail.com |
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Abstract: (315 Views) |
Background and Aim: Urinary tract infections (UTIs) are the second most common infections after respiratory infections. There are different types of UTI, all of which E.coli is known as the most common cause. Like other bacteria, this organism has become resistant to antibiotics. Some studies have reported the difference in antibiotic resistance in men and women of different ages. Knowledge of antibiotic resistance in any period and geographical region and in different people can play an important role in the correct prescription of antibiotics, especially the empirical therapy; Therefore, this study was conducted to investigate the antibiotic resistance pattern of uropathogenic E.coli isolated from urinary tract infections of outpatients.
Materials and Methods: This cross-sectional study was conducted from April 2021 to March 2022 on 7,365 urine culture samples of patients referred to the Kashan Reference Laboratory who were selected through the census. After taking a urine sample using the Mid-stream method under sterile conditions, bacteria were cultured on McConkey agar, blood agar, and selected media, and finally, after confirming E.coli isolates, antibiotic resistance was determined according to the guidelines of the Clinical and Laboratory Standards Institute and using the disc diffusion method on Muller-Hinton agar medium. For data analysis, SPSS ver. 16 and appropriate descriptive statistics and chi-square test were used, and the significance level was considered P-value less than 0.05.
Results: Among 401 positive urinary cultures, 251 samples (62.5%) were E.coli and 150 samples (37.4%) were other organisms. Among E.coli samples, 226 isolates (90%) were isolated from women and 25 isolates (10%) from men. The average age of women was 40.98 ± 22.42 and of men was 58.84 ± 24.96. E.coli strains showed the highest resistance with 54.7% to cefazolin and the lowest resistance with 4.4% to both imipenem and nitrofurantoin. Antibiotic resistance in E.coli isolated from men was higher than in women for all antibiotics used, and this difference was significant for all ceftriaxone, imipenem, ciprofloxacin, and nitrofurantoin. Also, the antibiotic resistance of E.coli at the age of 65 years and older increased to all the antibiotics used, and this increase was significant in all imipenem, ciprofloxacin, and cotrimoxazole.
Conclusion: According to the results of the present study, male gender and old age seem to play a role as two risk factors for increasing antibiotic resistance, at least in UTI cases. For empirical therapy, before culture results are prepared in patients with UTI, these differences should be taken into consideration and due to high antibiotic resistance, the prescription of ceftriaxone in men and ciprofloxacin in men and the elderly patients should be reconsidered. It should be noted that due to the high resistance to both cefazolin and cotrimoxazole in both sexes and different ages, it is suggested not to use these two antibiotics for the empirical therapy of UTI in the study area (Kashan).
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| Keywords: Urinary tract infections - Antibiotic resistance - Escherichia coli - gender -age |
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Type of Study: Research |
Subject:
medicine, paraclinic
Received: 2023/12/18 | Revised: 2024/03/17 | Accepted: 2024/03/17
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