Spectrum and patterns of antimicrobial resistance of uropathogens isolated from a sample of hospitalised Lebanese patients with urinary tract infections
Abstract: pective study was carried out to assess the current distribution and antimicrobial susceptibility patterns of uropathogens isolated from patients with community-acquired (CA) or hospital-acquired (HA) urinary tract infections (UTIs) who were admitted to the largest governmental hospital in Beirut City (Lebanon) in 2009–2012. Overall, 292 uropathogens were isolated. Enterobacteriaceae constituted 81% of the isolated uropathogens, with Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis being the most reported species. Moreover, 37% of the isolated uropathogens produced extended-Spectrum β-lactamases (ESBLs). ESBL-producing strains were more prevalent in CA-UTIs than in HA-UTIs. In the CA-UTI group, ESBL-producing strains were more prevalent in older patients (age >60 years), male patients and patients with diabetes mellitus, urinary catheterisation and benign prostatic hyperplasia. Uropathogens isolated from CA-UTI and HA-UTI had similar resistance patterns. The highest resistance rates were found for ampicillin, amoxicillin/clavulanic acid, trimethoprim/sulfamethoxazole and ciprofloxacin. Imipenem, nitrofurantoin and piperacillin/tazobactam showed good overall activity against the isolated uropathogens. Of the isolated non-ESBL-producing E. coli, 29% were found to be multidrug-resistant. These data suggest that there is an urgent need to implement a national policy regulating the use of antibiotics, notably in the community, in order to limit the widespread increase in antimicrobial resistance.
S. Kabbani, M.F. Anwar, R. Dbouk
Journal of Global Antimicrobial Resistance 2,volum 2 , page 173-178