Antimicrobial Resistance of Etiologic Agents in Adult Patients with Community-Acquired Urinary Tract Infections Hospitalized at the Clinic for Infectious Diseases in Tuzla

Dosadašnja istraživanja su pokazala da je antimikrobna rezistencija uzročnika infekcija mokraćnog sustava (IMS) u porastu i da je zemljopisno i vremenski varijabilna. Za uspješnu empirijsku antimikrobnu terapiju IMS potrebito je stalno praćenje antimikrobne rezistencije u određenoj regiji. Cilj našeg istraživanja bio je utvrditi antimikrobnu rezistenciju najčešćih uzročnika izvanbolničkih IMS u 200 odraslih bolesnika liječenih u Klinici za infektivne bolesti Tuzla u dvogodišnjem razdoblju (2007. i 2008. godine). Najčešći uzročnici IMS su Escherichia coli (73,5%), Klebsiella spp. (8,5%), Proteus mirabilis (5,5%), Pseudomonas aeruginosa (4%) i Enterococcus faecalis (3%). Escherichia coli je pokazala veliki postotak antimikrobne rezistencije na ampicilin, amoksicilin, amoksicilin/klavulonsku kiselinu i trimetoprim-sulfametoksazol, a nizak postotak antimikrobne rezistencije na ceftazidim, cefotaksim, ceftriakson, gentamicin, nitrofurantoin, norfloksacin, pipemidinsku kiselinu i ciprofloksacin. Klebsiella spp., Pseudomonas aeruginosa i Proteus mirabilis su pokazali veliki postotak antimikrobne rezistencije na sve antimikrobne lijekove osim na imipenem i meropenem. Enterococcus faecalis je pokazao veliki postotak antimikrobne rezistencije na amoksicilin/klavulonsku kiselinu, norfloksacin, eritromicin, gentamicin i trimetoprim-sulfametoksazol, a mali postotak antimikrobne rezistencije na vankomicin, ampicilin, amoksicilin, ciprofloksacin, doksiciklin i nitrofurantoin.The new investigations show that antimicrobial resistance of etiologic agents in urinary tract infections (UTI) is increasing and that it has a geographical and time variability. For empiric antimicrobial therapy in UTI it is necessary to monitor the antimicrobial resistance in certain region. The purpose of our investigation was to determine antimicrobial resistance of the most common etiologic agents in 200 adult patients with community-aquired UTI hospitalized at the Clinic for Infectious Diseases in Tuzla during 2007–2008. The most common etiologic agents were Escherichia coli (73.5%), Klebsiella spp. (8.5%), Proteus mirabilis (5.5%), Pseudomonas aeruginosa (4%) and Enterococcus faecalis (3%). Escherichia coli showed high percentage of antimicrobial resistance to ampicillin, amoxicillin, amoxicillin/clavulanic acid and trimethoprimsulphametoxazole, but low percentage of antimicrobial resistance to ceftazidim, cefotaxim, ceftriaxon, gentamycin, nitrofurantoin, norfloxacin, pipemidin acid and ciprofloxacin. Klebsiella spp., Pseudomonas aeruginosa and Proteus mirabilis showed high percentage of antimicrobial resistance to all antimicrobial agents except imipenem and meropenem. Enterococcus faecalis showed high percentage of antimicrobial resistance to amoxicillin/clavulanic acid, norfloxacin, erythromycin, gentamycin and trimethoprim/sulphametoxazole and low antimicrobial resistance to vancomycin, ampicillin, amoxicillin, ciprofloxacin, doxycyclin and nitrofurantoin