Antimicrobial Susceptibility and Uropathogens Isolated From Children and Adults with Community-Acquired Urinary Tract Infections

Objective: The aim of this study was to determine the distribution of uropathogens causing community-acquired urinary tract infections in Duzce, and their antimicrobial susceptibility patterns. Material and Methods: The study was conducted prospectively in the Duzce University Medical Faculty between July 2004-June 2006 and included outpatients. Identification of microbial growth and determination of antimicrobial susceptibility by the Kirby-Bauer disk diffusion technique were performed according to the Clinical and Laboratory Standards Institute. Results: In total, 702 bacterial isolates were examined in the study. E. coli (64.1%) was the most common urinary pathogen identified. Klebsiella spp. (9.0%), Proteus spp. (5.8%), Staphylococcus aureus (4.7%), Enterococcus spp. (4.3%), coagulase-negative Staphylococci (2.6%), S. agalactiae (2.1%) and P. aeruginosa (1.9%) were the next most common species isolated. Community acquired uropathogens isolated in our region were highly resistant to trimethoprim/sulfamethoxazole, amoxicillin and amoxicillin clavulanate. However, ciprofloxacin was active against pathogens examined in this study with susceptibilities between 64.7% and 88.8% for the most prevalent pathogens (E. coli, 81.0% susceptible). The susceptibility of gram-negative pathogens to the parenterall antibiotics seemed to be higher than the oral agents. Conclusion: Many oral antimicrobial agents do not seem to be appropriate for the empirical treatment of community-acquired urinary tract infections in our region due to very high rates of resistance. Some oral antibiotics such as ciprofloxacin and cefaclor should be used cautiously in adults