Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
August 2015 Vol. 4(8), pp. 321-330
Copyright © 2015 Global Advanced Research Journals

Full Length Research Paper

Prevalence and risk factors of community-acquired urinary tract infections due to ESBL-producing Gram negative bacteria in an Armed Forces Hospital in Sothern Saudi Arabia

TA El-Kersh^1*, MA Marie¹, YA Al-Sheikh¹, and SA Al-Kahtani²

¹Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
²Armed Forces Hospital Southern Region (AFHSR) Khamis Mushayt, Saudi Arabia

*Corresponding Author E-mail: talatkersh@yahoo.com; tkersh@ksu.edu.sa; Tel: +966114693734; Fax: +966114693738

Accepted 04 August, 2015

Abstract

This study investigated the prevalence and Antibiotic sensitivity profiles of Gram negative bacteria (GNB) isolated from urine specimens of out-patients with urinary tract infections (CA-UTI) in Armed Forces Hospital in southern Saudi Arabia, risk factors for infection, and extended spectrum β-lactamase production (ESBLs). The Vitek2 system (BioMe´rieux, France), was used for microbial identification, susceptibility testing, and ESBL detection, which was also confirmed by the Clinical and Laboratory Standards Institute  double-disk synergy test. A total of 269 GNB were studied.  E. coli accounted for 77 % (206/269), Klebsiella pneumoniae for 16 % (43/269) and other GNB 7% (20/269).   Fifty four % (23/43) of K. pneumoniae and 44% (91/206) of E coli isolates, were ESBL positive. Females comprised 74% (200/269) of patients, and 14% (37/269) were pregnant. Patients aged ≤10 years and those aged 71-80 years showed significant high risk to CA-UTI at frequency of 20.4 % (55/269) and 24.9 %(67/269) respectively. Unlike pregnancy, diabetic, cardiac, and/or renal disease-patients showed also high risk to CA-UTI by K. pneumonia.  E. coli, K. pneumoniae and other GNB susceptibility against meropenem, amikacin and gentamicin were 99%, 95 % and 85%; 88%, 88 % and 75%; and 75 %, 60 % and 70% respectively. While 53% and 25% of E coli isolates were resistant to TMP/SMZ and nitrofurantoin respectively. Seven Eterobacteriaceae isolates (E coli, 2; K pneumonia, 2; Serratia marcescens, 2 and Citrobacter freundii, 1) were resistant to all tested 14 drugs (pan-resistant isolates). Our findings identified risk factors which can be used to guide appropriate empiric therapy of CA-UTI, and targeted infection control measures.

Keywords: Community UTI, Risk factors, Vitek2, ESBL, pan-resistant isolates, E. coli, K. pneumoniae