Bacteriological profile of urinary tract infections in women in Aziza Othmana Hospital: A 495 cases study

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Lamia Thabet
Amen Allah Messadi
Balkis Meddeb
Mondher Mbarek
Amel Turki
Saida Ben Redjeb

Abstract

Background: Urinary infection is a frequent pathology in the community as well as at the hospital.
Aim: To analyze the profile of bacteria isolated from urinary tract infectious in women and their antimicrobial resistance.
Methods: During two year period (1 January 2005 to 31 December 2006), 4536 urinary specimens were analyzed at the Laboratory of Aziza Othmana Hospital. All bacteria isolated from urinary tract infection (UTI) at women were retrospectively reviewed.
Results: 495 cases of UTI were collected during this period. They were recovered from out patients (67%) or from hospitalized patients in Gynecology and obstetrics (23%). Enterobacteriacae were the most frequently identified strains (90.4%) including Escherichia coli (71%). The identified strains presented natural resistance and a high frequency of acquired resistance to betalactams(60.3% of E.coli, 72% of P.mirabilis were resistant to amoxicillin)and cotrimoxazole(30.4% of E.coli, 19,1 of K.pneumoniae, 21.4% of P.mirabilis). 5.7% of K.pneumoniae and 1.8% of E.coli were producing extended spectrum betalactamase(ESBL).
Aminoglycosides remained active on enterobacteriacae(resistance to amikacin<14%,gentamicin<5%).Ofloxacin was highly active against enterobacteriacae (resistance <14%)
Conclusion: Enterobacteriacae were the most frequent species in women urinary tract infection. Among these isolates, a high frequency of acquired resistance to betalactams and cotrimoxazole was shown. Aminoglysosides and fluoroquinolones remained the most active drugs. In every case antibiotherapy should have been prescribed after performing an antibiogram for each strain. These data were useful for the first line antibiotherapy, however the antimicrobial susceptibility testing is necessary for the rational use to limit the highly active drugs to multiresistant strains.

Keywords:

Urinary infection, antibiotic, resistance, antibiotherapy, Tunisia

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