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. 2023 Mar 3;12(1):1920.
doi: 10.4102/ajlm.v12i1.1920. eCollection 2023.

Antimicrobial susceptibility of bacterial uropathogens in a South African regional hospital

Alicia Naidoo  1   2 , Afsana Kajee  2   3 , Nomonde R Mvelase  1   2 , Khine Swe Swe-Han  2   3
Affiliations

Antimicrobial susceptibility of bacterial uropathogens in a South African regional hospital

Alicia Naidoo et al. Afr J Lab Med. .

Abstract

Background: Urinary tract infections are common bacterial infections affecting millions worldwide. Although treatment options for urinary tract infections are well established, with ciprofloxacin long considered one of the antibiotics of choice, increasing antibiotic resistance may delay the initiation of appropriate therapy. While this increase in antimicrobial resistance has been demonstrated in multiple studies around the world, there is a dearth of information from developing countries.

Objective: This study aimed to describe the antimicrobial susceptibility patterns of commonly isolated bacterial uropathogens in a South African hospital.

Methods: Antimicrobial susceptibility data of isolates obtained from urine specimens at the RK Khan Hospital, a regional hospital in KwaZulu-Natal, South Africa, between January 2018 and December 2020 were retrieved from the hospital's laboratory information system and analysed to determine the differences in resistance rates between the most frequently isolated bacterial uropathogens.

Results: Of the 3048 bacterial urinary pathogens isolated between 2018 and 2020, Escherichia coli (1603; 53%) was the most common, followed by Klebsiella spp. (437; 14%). Both E. coli and Klebsiella spp. showed high rates of resistance to amoxicillin/clavulanic acid (29.8% and 42.3%) and ciprofloxacin (37.7% and 30.4%). Nitrofurantoin resistance was low among E. coli (6.2%) but high among Klebsiella spp. (61.3%).

Conclusion: E. coli and Klebsiella spp. in this study were highly resistant to amoxicillin/clavulanic acid and ciprofloxacin, two of the frequently prescribed oral treatment options.

What this study adds: This study highlights the importance of regular local antimicrobial resistance surveillance to inform appropriate empiric therapy.

Keywords: antibiotic resistance; antimicrobial susceptibility patterns; urinary oral treatment; urinary pathogens; uropathogens.

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Conflict of interest statement

The authors declare that they have no financial or personal relationship that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Distribution of the 3048 bacterial urinary pathogens isolated at the RK Khan Hospital, Durban, KwaZulu-Natal, South Africa, January 2018 – December 2020.
FIGURE 2
FIGURE 2
Antimicrobial susceptibility rates of E. coli and Klebsiella spp. isolated from patients with suspected urinary tract infections at the RK Khan Hospital, Durban, KwaZulu-Natal, South Africa, January 2018 – December 2020. The total number of isolates is different for each antimicrobial due to missing results linked to random terminations that can sometimes occur during automated antimicrobial susceptibility testing with the VITEK® 2 instrument.
FIGURE 3
FIGURE 3
Antimicrobial susceptibility trends of E. coli isolated from patients with suspected urinary tract infections at the RK Khan Hospital, Durban, KwaZulu-Natal, South Africa, January 2018 – December 2020. The total number of isolates is different for each antimicrobial due to missing results linked to random terminations that can sometimes occur during automated antimicrobial susceptibility testing with the VITEK® 2 instrument.
See this image and copyright information in PMC

References

    1. Van Schoor J. Urinary tract infection in women. S Afr Fam Pract. 2016;58(1):6–10. 10.4102/safp.v58i1.4434 - DOI
    1. Raja NS. Oral Treatment options of patients with urinary tract infections caused by extended spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae. J Infect Public Health. 2019;12(6):843–846. 10.1016/j.jiph.2019.05.012 - DOI - PubMed
    1. Schmiemann G, Kniehl E, Gebhardt K, Matejczyk MM, Hummers-Pradier E. The diagnosis of urinary infection. Deutsches Ärzteblatt Int. 2010;107(21):361–367. 10.3238/arztebl.2010.0361 - DOI - PMC - PubMed
    1. Zur Wiesch PA, Kouyos R, Engelstädter J, Regoes RR, Bonhoeffer S. Population biological principles of drug-resistance evolution in infectious diseases. Lancet Infect Dis. 2011;11(3):236–247. 10.1016/S1473-3099(10)70264-4 - DOI - PubMed
    1. Read AF, Woods RJ. Antibiotic resistance management. Evol Med Public Health. 2014;28(1):147. 10.1093/emph/eou024 - DOI - PMC - PubMed

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