Assessment of Antibiotic Resistance Pattern and Frequency of Gram-positive Bacteria Isolated from Urine Samples in Bandar Torkman

Authors
Mohammad Bartimar 1
Ania Ahani Azari 1
Ahmad Danesh 2
1 Department of Microbiology, Gorgan Branch, Islamic Azad University, Gorgan, Iran
2 Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
Abstract
Introductions: As antibiotic resistance in uropathogens is increasing, information on the most common etiologic agents and their antibiotic susceptibility are highly important. The aim of this study was to determine antibiotic resistance pattern of Gram-positive uropathogens isolated from urine specimens referred to clinical laboratories in Bandar Turkmen.

Materials and Methods: Urine samples of patients suspected of urinary tract infection were collected from April through May 2016. From 367 positive urine samples, 89 samples were positive for Gram-positive Europathogens, using standard microbiological and biochemical tests. Then, antibiotic resistance patterns were determined by disk diffusion method.

Results: The most isolated were Staphylococcus epidermidis (30), Streptococcus group B (28), Non-heamolytic streptococci (10) and Enterococci (7), Staphylococcus saprophyticus (6), Alpha-heamolytic Streptococci (5) and Micrococci (3) and the highest resistance was observed to ampicillin and cotrimoxazole. Moreover, all the isolates were sensitive to vancomycin.

Conclusion: It is found that the most common causes of UTI were Staphylococcus epidermidis and Streptococcus group B, whichhad the highest antibiotic resistance to cotrimoxazole and ampicillin. They were also most susceptible to vancomycin, amikacin and ceftizoxime. Therefore, these antibiotics can be used in the empiric therapy of UTIs.

.
Keywords
Antibiotic resistance
Gram-positive bacteria
Urinary tract infections
1 Osthoff M, McGuinness SL, Wagen AZ, Eisen DP. Urinary tract infections due to extended-spectrum beta-lactamase-producing Gram-negative bacteria: identification of risk factors and outcome predictors in an Australian tertiary referral hospital. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2015;34:79-83.
2 Simmering JE, Tang F, Cavanaugh JE, Polgreen LA, Polgreen PM. The Increase in Hospitalizations for Urinary Tract Infections and the Associated Costs in the United States, 1998-2011. Open forum infectious diseases. 2017;4(1):ofw281.
3 Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. The American journal of medicine. 2002;113 Suppl 1A:5s-13s.
4 Foxman B, Barlow R, D'Arcy H, Gillespie B, Sobel JD. Urinary tract infection: self-reported incidence and associated costs. Annals of epidemiology. 2000;10(8):509-15.
5 Amin M MM, Pourdangchi Z. Study of bacteria isolated from urinary tract infections and determination of their susceptibility to antibiotics. Jundishapur J Microbiol. 2009;2(3):118-23.
6 Baghani AH, Ekrami TM, HAGHIGHI F, TABARRAIE Y. Common Bacterial Factors of Urinary Tract Infections and Determining their Antibiotic Resistance in Hospitalized and out Patients Referred to the Vase’ee Hospital in Sabzevar in 2016. 2018.
7 Bitew A, Molalign T, Chanie M. Species distribution and antibiotic susceptibility profile of bacterial uropathogens among patients complaining urinary tract infections. BMC infectious diseases. 2017;17(1):654.
8 Kanani M MH, khazaei S, Shahi M. . The pattern of antibiotic resistant Gram-negative bacilli isolated from urine samples for Imam Reza Hospital-(Kermanshah). Urmia Med J 2010;21(1):75-81.
9 Zhanel GG, Hisanaga TL, Laing NM, DeCorby MR, Nichol KA, Palatnik LP, et al. Antibiotic resistance in outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). International journal of antimicrobial agents. 2005;26(5):380-8.
10. Gul N Y, Mujahid T, Ahmad S. . Isolation, identification and antibiotic resistance profile of indigenousbacterial isolates from urinary tract infection patients. Pakistan Journal of Biological Sciences. 2005;7(12):2051-4.
11. Lorente-Garin JA PS, Salvado CM, Segura AC, Gelabert-Mas A. Antibiotic resistance transformation in community acquired urinary infections. Revista Clinica Espanola. 2005;205: 259-64.
12. Kline KA, Lewis AL. Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract. Microbiol Spectr. 2016;4(2).
13. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Disease-a-month : DM. 2003;49(2):71-82.
14. Kumari N, Rai A, Jaiswal CP, Xess A, Shahi SK. Coagulase negative Staphylococci as causative agents of urinary tract infections-prevalence and resistance status in IGIMS, Patna. Indian journal of pathology & microbiology. 2001;44(4):415-9.
15. Piette A, Verschraegen G. Role of coagulase-negative staphylococci in human disease. Veterinary microbiology. 2009;134(1-2):45-54.
16. Manges AR, Natarajan P, Solberg OD, Dietrich PS, Riley LW. The changing prevalence of drug-resistant Escherichia coli clonal groups in a community: evidence for community outbreaks of urinary tract infections. Epidemiology and infection. 2006;134(2):425-31.
17 Vromen M vdVA, Knols A, Stobberingh EE. Antimicrobial resistance patterns in urinary tract isolates from nursing home residents. Fifteen years of data reviewed. J Antimicrobial Chemother 1999;44:113–6.
18. Doern GV, Vautour R, Gaudet M, Levy B. Clinical impact of rapid in vitro susceptibility testing and bacterial identification. Journal of clinical microbiology. 1994;32(7):1757-62.
19. Tayebi Z, Sadat Seyedjavadi S, Goudarzi M, Rahimi MK, Boromandi S, Zaker Bostanabad S, et al. Frequency and antibiotic resistance pattern in gram positive uropathogenes isolated from hospitalized patients with urinary tract infection in Tehran, Iran. The Journal of Genes, Microbes and Immunity. 2014;2014:1-9.
20. AHB. W. Clinical guide to laboratory tests. Elsevier. 2006;8:1620-2.
21. Forbes B. A SDF, Weissfeld A. S. . Bailey and Scott's Diagnostic microbiology. Mosby Elsevier,. 2007;12th edition:842-55.
22. Mandell G. L BJE, Dolin R. . Principles and practice of infectious diseases. Churchill Livingstone. 2005:881-2.
23. al. WMPe. Performance standards for antimicrobial disk susceptibility tests. Clinical and Laboratory Standards Institute. 2019;29th edition:150.
24. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2012;18(3):268-81.
25. Mihankhah A, Khoshbakht R, Raeisi M, Raeisi V. Prevalence and antibiotic resistance pattern of bacteria isolated from urinary tract infections in Northern Iran. Journal of Research in Medical Sciences. 2017;22(1):108-.
26. Seraj S MK, Ghorbani A, Eatemadi A ,Cheraghi M, Mahmoodlo A , Nikbakhtian N. Identify bacteria responsible for urinary tract infections and antibiotic sensitivity. J Lorestan Uni Med Sci 2004;6(23):41-7.
27. Beyene G TW. Bacterial Uropathogens in Urinary Tract Infection and Antibiotic Susceptibility Pattern in Jimma University Specialized Hospital, Southwest Ethiopia. Ethiopian journal of health sciences. 2011; 21(2):141-6.
28. Abuhandan M, Guzel B, Oymak Y, Ciftci H. Antibiotic sensitivity and resistance in children with urinary tract infection in Sanliurfa. Turk J Urol. 2013;39(2):106-10.
29. Grude N TY, Kristiansen BE. Urinary tract infections in Norway: bacterial etiology and susceptibility. A retrospective study of clinical isolates. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2001;7(10):543-7.
30. Paul R. State of the Globe: Rising Antimicrobial Resistance of Pathogens in Urinary Tract Infection. J Glob Infect Dis. 2018;10(3):117-8.