DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160813

Prevalence and antimicrobial susceptibility patterns of uropathogenic E. coli among people in Zakho, Iraq

Reem Fouad Polse, Samira Younis Yousif, Mahde Saleh Assafi

Abstract


Background: Antimicrobial resistance in uropathogenic E. coli is of major concern worldwide due to its increasing resistance to several commonly prescribed antibiotics. The aims of this study were to determine the prevalence and to evaluate the presence and antibiogram pattern of uropathogenic E. coli among people in Zakho city, Iraq.

Methods: 1120 urine samples were collected from people. Samples were screened for E. coli isolates and their susceptibility to different antibiotics was analyzed.

Results: Diagnoses tests showed that only 106 (9.4%) isolates were E. coli. Females (90, 85%) were more susceptible to urinary tract infections (UTIs) than males (16, 15%) (p <0.05). The age 11-21 years old (23, 21.7%) was the most affected group (p <0.05). All isolates were resistant to penicillin, ampicillin and aztreonam. While, all these isolates were sensitive to imipenem and meropenem.

Conclusions: The incidence of uropathogenic E. coli among people is comparable with reports from elsewhere. E. coli isolates are highly susceptible towards imipenem, and meropenem antibiotics, and highly resistant towards β-lactam and cephalosporins antibiotics. Education programs and improving the hygienic measures are necessary to prevent contaminations with E. coli and minimize the use of β-lactam and cephalosporin antibiotics.


Keywords


Uropathogens, E. coli, Antimicrobial resistance, Iraq

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References


Kaper JB, Nataro JP, Mobley HL. Pathogenic Escherichia coli. Nat Rev Microbiol. 2004;2(2):123-40.

Russo TA, Johnson JR. Extra intestinal isolates of Escherichia coli: identification and prospects for vaccine development. Expert Rev Vaccines. 2006;5(1):45-54.

Santo E, Macedo C, Marin JM. Virulence factors of uropathogenic Escherichia coli from a university hospital in Ribeirao Preto, Sao Paulo, Brazil. Rev Inst Med Trop Sao Paulo. 2006;48(4):185-8.

Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002;113(1A):5-13.

Nicolle LE. Urinary tract infection in geriatric and institutionalized patients. Curr Opin Urol. 2002;12(1):51-5.

De Kraker ME, Wolkewitz M, Davey PG, Koller W, Berger J, Nagler J. Burden of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins. J Antimicrob Chemother. 2011;66(2):398-407.

Aarestrup FM. Veterinary drug usage and antimicrobial resistance in bacteria of animal origin. Basic Clin Pharmacol Toxicol. 2005;96(4):271-81.

Wilke MS, Lovering AL, Strynadka NC. Beta-lactam antibiotic resistance: a current structural perspective. Curr Opin Microbiol. 2005;8(5):525-33.

Bush K, Macielag MJ. New beta-lactam antibiotics and beta-lactamase inhibitors. Expert Opin Ther Pat. 2010;20(10):1277-93.

Da Costa PM, Loureiro L, Matos AJ. Transfer of multidrug-resistant bacteria between intermingled ecological niches: the interface between humans, animals and the environment. Int J Environ Res Public Health. 2013;10(1):278-94.

MacFaddin JF. Biochemical Tests for Identification of Medical Bacteria. 3rd ed. Philadelphia, PA, USA: Lippincott Williams and Wilkins; 2000. th ed. Philadelphia, PA, USA: F.A. Davis Company. 2012.

Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966;45(4):493-6.

CLSI. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing; fifteenth informational supplement. CLSI-NCCLS document M100-S15. Clinical and laboratory standards institute, wayne, PA. 2004.

Collee JG, Frascr AG, Marmion BP, Simmons A. Mackie and MacCartney Practical Medical Microbiology. 4th ed. New York, USA: Churchill Livingstone. 1996.

Stamm WE, Norrby SR. Urinary tract infections: disease panorama and challenges. J Infect Dis. 2001;183(1):S1-4.

Khalid HM. Molecular epidemiology of extended spectrum β-lactamase producing Klebsiella pneumoniae using specific primers (TEM, SHV, CTX-M) in Kurdistan Region-Iraq. PhD, Zakho University, Zakho, Iraq. 2013.

Al-Jebouri MM, Mdish SA. Antibiotic Resistance Pattern of Bacteria Isolated from Patients of Urinary Tract Infections in Iraq. Open Journal of Urology. 2013;3:124-131.

Abdulkareem HA, Marwah HA, Fatma AO. Efficacy of combination of nitrofurantoin with gentamicin, and Ciprofloxacin against resistant E. coli isolated from patients with Urinary tract infections: in vitro study. Mintage journal of Pharmaceutical & Medical Sciences. 2014;3(2):5-9.

Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in J N M C Hospital Aligarh, India. Ann Clin Microbiol Antimicrob. 2007;6:4.

Kothari A, Sagar V. Antibiotic resistance in pathogens causing community acquired urinary tract infection in India: a multicenter study J. Infect. Developing Countries. 2008;2(5):354-8.

Turpin C, Minkah B, Danso K, Frimpong E. Asymptomatic bacteriuria in pregnant women attending antenatal clinic at komfo anokye teaching hospital, kumasi, ghana. Ghana Med J. 2007;41(1):26-9.

Bien J, Sokolova O, Bozko P. Role of Uropathogenic Escherichia coli Virulence Factors in Development of Urinary Tract Infection and Kidney Damage. Int J Nephrol. 2012;2012:1-15.

Merza NS. Clonal grouping of uropathogenic Escherichia coli using different molecular typing methods in Kurdistan Region-Iraq. PhD, Zakho University, Zakho, Iraq. 2013.

Foxman B, Brown P. Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs. Infect Dis Clin North Am. 2003;17(2):227-41.

Yamamoto S, Tsukamoto T, Terai A, Kurazono H, Takeda Y, Yoshida O. Genetic evidence supporting the fecal-perineal-urethral hypothesis in cystitis caused by Escherichia coli. J Urol. 1997;157(3):1127-9.

Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010;7(12):653-60.

Wiles TJ, Kulesus RR, Mulvey MA. Origins and virulence mechanisms of uropathogenic Escherichia coli. Exp Mol Pathol. 2008;85(1):11-9.

Kiffer CR, Mendes C, Oplustil CP, Sampaio JL. Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city. Int Braz J Urol. 2007;33(1):42-8.

Prakash D, Saxena RS. Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of meerut city, India. ISRN Microbiol. 2013;2013:749629.

Moyo SJ, Aboud S, Kasubi M, Lyamuya EF, Maselle SY. Antimicrobial resistance among producers and non-producers of extended spectrum beta-lactamases in urinary isolates at a tertiary Hospital in Tanzania. BMC Res Notes. 2010;3:348.

Sabir S, Ahmad AA, Ijaz T, Asad Ali M, Khan

URM, Nawaz M. Isolation and antibiotic susceptibility of E. coli from urinary tract infections in a tertiary care hospital. Pak J Med Sci. 2014;30(2):389-92.

Sana T, Rami K, Racha B, Fouad D, Marcel A, Hassan M. Detection of genes TEM, OXA, SHV and CTX-M in 73 clinical isolates of Escherichia coli producers of extended spectrum Beta-lactamases and determination of their susceptibility to antibiotics. International Arabic Journal of Antimicrobial Agents. 2011;1(1):1-6.

Rupp ME, Fey PD. Extended Spectrum β-Lactamase (ESBL)-Producing Enterobacteriaceae. Drugs. 2003;63(4):353-65.

Kanj SS, Kanafani ZA. Current concepts in antimicrobial therapy against resistant gram-negative organisms: extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, and multidrug-resistant Pseudomonas aeruginosa. Mayo Clin Proc. 2011;86(3):250-9.

Bradford PA. Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev. 2001;14(4):933-51.

Dhillon RH, Clark J. ESBLs: A Clear and Present Danger? Crit Care Res Pract. 2012;2012:1-11.

Brunton J, Clare D, Meier MA. Molecular epidemiology of antibiotic resistance plasmids of Haemophilus species and Neisseria gonorrhoeae. Rev Infect Dis. 1986;8(5):713-24.

Kumar D, Singh AK, Ali MR, Chander Y. Antimicrobial Susceptibility Profile of Extended Spectrum beta-Lactamase (ESBL) Producing Escherichia coli from Various Clinical Samples. Infect Dis (Auckl). 2014;7:1-8.

Drawz SM, Bonomo RA. Three decades of beta-lactamase inhibitors. Clin Microbiol Rev. 2010;23(1):160-201.

Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev. 2005;18(4):657-86.