RISK FACTORS AND ANTIBIOTIC RESISTANCE SPREAD AMONG PATIENTS WITH URINARY TRACT INFECTIONS IN KERBALA, IRAQ

Zahra H. Al-Wazni; Saif Ahmed Raheem; Fatimah H. Zayed; Hussein Amer Faraj; Mohammed Alaa Abdulzahra

doi:10.46903/gjms/22.02.1635

RISK FACTORS AND ANTIBIOTIC RESISTANCE SPREAD AMONG PATIENTS WITH URINARY TRACT INFECTIONS IN KERBALA, IRAQ

Zahra H. Al-Wazni, Saif Ahmed Raheem, Fatimah H. Zayed, Hussein Amer Faraj, Mohammed Alaa Abdulzahra

Abstract

Background: The most frequent infection that requires hospitalization is a urinary tract infection (UTI), which is frequently linked to gram-negative multidrug-resistant organisms (MDROs). This study aims to identify the kind of urine pathogens isolated from patients as well as their pattern of antibiotic resistance and relationship with the risk factors. During the period extending between October 2023 to January 2024.

Materials & Methods: Urine samples from 30 healthy controls and 50 probable UTI patients, ranging in age from 9 to 69, were collected. Sampling was done in the private clinic and Al-Kafeel hospital. The Vitek system was utilized to identify the bacterial growth, and before taking the sample, a questionnaire was taken from the patient, including age, gender, place of residence, whether or not he suffers from diseases related the urinary system ,and family history of the diseases.

Results: The findings indicated that the percentage of infection in females (56%, n=28) was higher than that in males (40%, n=20). In addition, in the 20-29 age group, there was the highest rate of infection, while the 60-69 age group had the lowest rate of infection. Out of 50 urine samples, the results also showed that 2 (4%) had no bacterial growth and 48 (96%) had considerable bacterial growth; only these samples were used in the current study. The bacterial isolates included 19/48 (38%) Escherichia coli, 11/48 (22%) Klebsiella pneumoniae, 8/48 (16%) Enterococcus faecalis, 6/48 (12%) Staphylococcus aureus, 4/48 (8%) Pseudomonas aeruginosa.

Conclusion: In gram-negative bacteria, meropenem was mostly effective antibiotic, followed by doxycycline. However, in Gram-positive bacteria, linezolid is most effective antibiotic. Among risk factors for the UTIs and MDR-UTIs spread included a previous UTI (n=31, 62%), sexual activity (n=47, 94%), older age (n=29, 58%) and recent pregnancy (n=26, 52%). Determination of risk factors of UTIs is important needing prompt control strategies.

Keywords

Urinary tract infections; Risk factors; antibiotic resistance; Kerbala; Iraq.

Full Text:

PDF

References

Matsumoto T, Kumazawa J. Urinary tract infection. Vol. 51 Suppl, Nippon rinsho. Japanese journal of clinical medicine. 1993. p. 492-502.

Smelov V, Naber K, Bjerklund Johansen TE. Improved Classification of Urinary Tract Infection: Future Considerations. Vol. 15, European Urology, Supplements. 2016. p. 71-80. https://doi.org/10.1016/j.eursup.2016.04.002

Ferry SA, Holm SE, Stenlund H, Lundholm R, Monsen TJ. Clinical and bacteriological outcome of different doses and duration of pivmecillinam compared with placebo therapy of uncomplicated lower urinary tract infection in women: The LUTIW project. Scand J Prim Health Care. 2007;25(1):49-57. https://doi.org/10.1080/02813430601183074

Masaoodi NNHAL, Atallah AH, Hameed ZC. Detection of bacteria in urinary tract infection among prenatal patients in hospitals, Karbala, Iraq. J Surv Fish Sci. 2023;10(3S):1502-13.

Hickling DR, Sun T-T, Wu X-R. Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection. Microbiol Spectr. 2015;3(4). https://doi.org/10.1128/microbiolspec.UTI-0016-2012

Evans MM. Urinary tract infection in older adults. Vol. 42, Nursing. 2012. p. 72. https://doi.org/10.1097/01.NURSE.0000412932.50878.9c

Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis in children. Vol. 31, Pediatric Nephrology. 2016. p. 1253-65. https://doi.org/10.1007/s00467-015-3168-5

Ahmed SS, Shariq A, Alsalloom AA, Babikir IH, Alhomoud BN. Uropathogens and their antimicrobial resistance patterns: Relationship with urinary tract infections. Int J Health Sci (Qassim). 13(2):48-55.

Chu MC, Lowder JL. Diagnosis and treatment of urinary tract infections across age groups. Am J Obstet Gynecol. 2018;219(1):40-51. https://doi.org/10.1016/j.ajog.2017.12.231

Mazzariol A, Bazaj A, Cornaglia G. Multi-drug-resistant Gram-negative bacteria causing urinary tract infections: a review. J Chemother. 2017;29:2-9. https://doi.org/10.1080/1120009X.2017.1380395

Yasir M, Ajlan AM, Shakil S, Jiman-Fatani AA, Almasaudi SB, Farman M, et al. Molecular characterization, antimicrobial resistance and clinico-bioinformatics approaches to address the problem of extended-spectrum β-lactamase-producing Escherichia coli in western Saudi Arabia. Vol. 8, Scientific Reports. 2018. https://doi.org/10.1038/s41598-018-33093-8

Oteo J, Pérez-Vázquez M, Campos J. Extended-spectrum β-lactamase producing Escherichia coli: Changing epidemiology and clinical impact. Vol. 23, Current Opinion in Infectious Diseases. 2010. p. 320-6. https://doi.org/10.1097/QCO.0b013e3283398dc1

Tanis W, Meijs M, Groutars R, The HKS, ... Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial. Lancet. 2020;1895-904. https://doi.org/10.3410/f.739033765.793589943

AL-Khikani FO, Auda GA, Ayit A. Correlation study between urinary tract bacterial infection and some acute inflammatory responses. Biomed Biotechnol Res J. 2019;3(4):236. https://doi.org/10.4103/bbrj.bbrj_122_19

John F, Saeed NA, Nadeem S, Hamed M. Integration of planting time and insecticide used to manage aphid infestations in wheat for better crop productivity. Vol. 49, Pakistan Journal of Zoology. 2017. p. 1343-51. https://doi.org/10.17582/journal.pjz/2017.49.4.1343.1351

Alhamedy AJ, Shani WS. Determination of cathelicidin in UTI patients of basrah province. Ann Trop Med Public Heal. 2020;23(2):182-9. https://doi.org/10.36295/ASRO.2020.23225

Storme O, Saucedo JT, Garcia-Mora A, Dehesa-Dávila M, Naber KG. Risk factors and predisposing conditions for urinary tract infection. Vol. 11, Therapeutic Advances in Urology. 2019. p. 19-28. https://doi.org/10.1177/1756287218814382

Yongzhi L, Shi Y, Jia L, Yili L, Xingwang Z, Xue G. Risk factors for urinary tract infection in patients with urolithiasis - Primary report of a single center cohort. BMC Urol. 2018;18(1). https://doi.org/10.1186/s12894-018-0359-y

Said A, El-Gamal MS, Abu-Elghait M, Salem SS. Isolation, Identification and Antibiotic Susceptibility Pattern of Urinary Tract Infection Bacterial Isolates. Vol. 10, Letters in Applied NanoBioScience. 2021. p. 2820-30. https://doi.org/10.33263/LIANBS104.28202830

Al-Tiaa HA, Al-Ghanim AAK. Isolation and identification of some bacterial species causing urinary tract infections in Holy Karbala Iraq. In: AIP Conference Proceedings. 2022. https://doi.org/10.1063/5.0113486

Madeeha Mehboob, Malik Nawaz Shuja. Isolation, Identification and Characterization of Urinary Tract Infectious Bacteria and the Effect of Different Antibiotics. Biosci Rev. 2021;3(3). https://doi.org/10.32350/BSR.0303.04

DOI: https://doi.org/10.46903/gjms/22.02.1635