THE ETIOLOGICAL SPECTRUM AND ANTIBIOTIC RESISTANCE PATTERN OF BACTERIA CAUSING UNCOMPLICATED URINARY TRACT INFECTIONS: A TEN-YEAR SURVEILLANCE STUDY (2005-2015)
Abstract
Background and objective. Knowledge of local antimicrobial resistance pattern is very important for evidence-based empirical antibiotic prescribing. The main objective of the present study was to evaluate the prevalence and the antimicrobial resistance pattern of the main bacteria responsible for uncomplicated urinary tract infection (UTI) in Kyiv region (Ukraine), throughout a ten year period, in order to establish an appropriate empirical therapy.
Materials and methods. A retrospective analysis of the etiological spectrum and antimicrobial resistance of uropathogens in urine samples isolated over the 10-year period, 2005 to 2015, in a single center was performed.
Results. In total 380positive urine samples processed at our laboratory of which 193/380 (51 %) had E. coli as the infecting organism. Although E. coli was, as usual, the most common pathogen implicated in UTI, it were observed increasing the share of Enterococcus spp. - 82/380 (21.6%). Ampicillin and trimethoprim were the least-active agents against E. coli with resistance rates of 75% and 70%, respectively. Significant trends of increasing resistance over the 10-year period were identified for trimethoprim, fluoroquinolones ІІ and III generations, penicillins, and carbapenems. Nitrofuran derivative remains a reasonable empirical antibiotic choice in this community with a 10-year resistance rate of 8.3 %. Was
determined that recurrent UTI is an independent risk factor for bacterial multidrug-resistance.
Conclusions. Over the last 10 years, the proportions of fluoroquinolones resistant E. coli and multidrug-resistant bacteria have significantly increased. The fluoroquinolones shall not be used in the empirical treatment of uncomplicated
UTI in Kyiv region patients. For the empirical treatment of uncomplicated UTI in women should be used nitrofuran derivative (furazydyn K). If required of parenteral administration of antibiotics should be used cephalosporins IVgeneration. This data will enable evidence-based empirical prescribing which will ensure more effective treatment and lessen the emergence of resistant uropathogens in the community.
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