MULTIPLE DRUGS RESISTANCE AMONG URINARY TRACT INFECTION PATIENTS IN DUHOK CITY –KURDISTAN REGION –IRAQ
Abstract
Background:Anti-microbial resistance could be a major public-health problem worldwide and universal endeavors are required to counteract its rise and the moment most common reason for observational antibiotic treatment. Optimal treatment seems diminish mortality and morbidity in surgical patients and play a crucial part in combating the continuous emergencies of expanding antibiotic resistance. The aim of this study is to study the pathogens and their antibiotic susceptibility in urinary cultures to Central laboratory in Duhok City and to study the rationality of antibiotic treatment urinary tract infection. Patients and Methods:One hundred fifty-one UTI urine samples (culture positive) were collected from patient of central laboratory. Identified and isolated bacteria were determined by biochemical tests like Gram staining, Indole, oxidase, catalase, methyl red, Voges-Proskauer, citrate utilization, hemolysis, motility; and urea; fermentation and utilization tests of glucose, lactose and sucrose. Sensitivity pattern of isolates was determined against some traditional and conventional antibiotics.Results:Staphylococcus aureus was the most common bacteria (40.4 %) followed by E.coli (31.8%). The overall levels of resistance to commonly used antibiotics were moderate in all pathogens. Amikacin and Nitrofurantoin were generally the antibiotics with lowest rates of resistance. Aminoglycosides and Fluoroquinolones were the most often used antibiotics. In first-line treatment, only 55 % of cases were given at least one antibiotic to which the bacteria were sensitive. A statistically significant higher resistant to both Amoxicillin and Erythromycin were found in cultures from UTI patients (P = 0.02 and P = 0.002). Conclusions:Commonly encountered bacteria in this study which are Staphylococcus, Escherichia coli and Klebsiella were found to be highly sensitive to Nitrofurantoin, Amikacin and, to lesser extent, to ciprofloxacin, while low sensitivity pattern was recorded against Amoxicillin and Gentamicin, pointing to that antibacterial misuse is the leading cause for their resistance. The most commonly prescribed antibacterial Trimethoprim.
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