Analysis of Bacterial Uropathogens and Antimicrobial Resistance Profiles among Diabetic Patients in Al-Kut City, Iraq
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Urinary tract infection (UTI) is a serious medical concern that results from microbial colonization and spread inside the urinary system. Because their host defenses are weakened and their urine has a high glucose content, patients with diabetes are more susceptible to bacterial UTIs. Patient treatment and infection control depend on uropathogens and their antibiograms being thoroughly and promptly examined.
Objectives: This study was performed to evaluated the prevalence of bacterial uropathogens and patterns of antibiotic resistance in individuals with diabetes in al-Kut City, Iraq
Methods: Between January 2023 and February 2024, 420 urine samples from outpatient admissions to Al-Karama and Al-Zahraa Teaching Hospitals were used in this investigation. The identification and antibiotic susceptibility tests of the causing bacteria were conducted using the fully automated VITEK 2 compact system.
RESULTS: Out of 420 urine samples from symptomatic UTI patients, 344 (81.9%) were determined to have significant growth for UTI; 292 (84.88%) of them were females patients. The Gram negative bacteria were detected in 212 (61%) of samples, while the gram positive bacteria were isolated from 123 (38%) of samples . Regardless of the sex group, E. Coli and S. aureus were the most frequently isolated uropathogens in percentage of 71.69% and 38.38%, respectively. The "resistance rates in the group of Gram-negative isolates (n=389) in decreasing order were as follows: Ampicillin 65% Cefoxitin 49< Piperacillin/tazobactam 47% < Ceftriaxone 35% < Ceftazidime and Cefepime 29% <Trimethoprim/Sulfamethoxazole 27%<Ciprofloxacin 24% Levofloxacin 23%<Nitrofurantoin 22%< Gentamicin 19%<Amikacin 18% <Imepenem 2%” .on the other hand, The resistance rates in the group of Gram-positve isolates (n= 132) in decreasing order were “Oxacillin 49% <Tetracycline 46% Trimethoprim/sulfamet hoxazole 45%<Levofloxacin 26% < Nitrofurantion and Tobramycin 20%< Clindamycin 16%< , Rifampicin 11%<< Gentamicin 11% <Teicoplanin and Vancomycin 6%”
CONCLUSION: E. coli and S. aureus dominated the etiological spectrum of UTIs in AL-Kut City, Iraq. There was a relatively low resistance rate to aminoglycosides among the Gram-negative uropathogens, but significant resistance rates to "trimethoprim/sulfamethoxazole", ampicillin, and second and "third-generation cephalosporins" were detected. In the G+ group,Vancomycin, teicoplanin, and imipenem all maintained very excellent action and are suitable options for the antimicrobial therapy of complex urinary tract infections in the absence of other options.
Keywords
al-Kut City, Uropathogens, Antimicrobial Resistance, Diabetes