Prevalence of Antimicrobial Resistance in Uro- pathogens Isolated from Patients with Community- acquired Urinary Tract Infection

Abstract

This study was carried out in Khartoum State. Patients with community-acquired urinary tract infection attended to Ibrahim Malik and Khartoum Teaching Hospitals during the period February to April 2009. A total of 103 urine specimens were collected. They were cultured on Blood and MacConkey's agar's for primary isolation of pathogen, identification of the pathogens were done by colonial morphology, gram stain and biochemical testes using API 20 E .Modified Kirby-Bauer disc diffusion method was adopted to determine the resistance rate of pathogens above against (nitrofuratoin, amoxycillin, nalidixic acid, co- trimoxazole and amoxyclav). Minimum Inhibitory Concentration MIC of antibiotic above was determining by E-test. Sixty five (65) (63.11%) specimens were found growth and (38) (36.89%) were not growth. E. coli was show to be the most common bacteria isolated (39) (60%) followed by K. pneumonia (11) (16.93%) followed by S. aureus (7) (10.76%) followed by P. mirabilis (6) (9.23%) and followed by Ps. aeruginosa (2) (3.07%). Antimicrobial susceptibility analysis revealed that resistance rate of E. coli was (66.6%) to amoxycillin which is highly resistance. The MIC of E. coli lowest in co-trimoxazole (0.1-1μg/ml). The MIC 50 and MIC of antibiotic with E. coli were also lowest in co-trimoxazol were (0.5 μg/ml) (1 μg/ml) respectively. Study on antimicrobial susceptibility test revealed that the highly resistance rate of K. Pneumonia was (100 %) to amoxycillin. The low MIC was amoxyclav (0.01 - >240 μg/ml).The MIC50 and MIC90 were low to amoxyclav and amoxicillin (4 μg/ml) (<240μg/ml), resistance rate of S. aureus was highly (85.7%) in amoxyclav.MIC of co-trimoxazole was (0.1 μg/ml) lowest one. MIC50 and MIC90 were also low in co-trimoxazole (0.1μg/ml) in both, P. mirabilis resistance rate was (100%) to amoxyclav which is highly resistance. MIC of amoxyclav was (60-120 μg/ml).The MIC50 and MIC90 were (0.5 μg /ml) to co-trimoxazol. While in Ps. aeruginosa were (100%) to nitrofuration, amoxycillin, co-trimoxazole and amoxyclav. MIC of nalidixic acid and co- trimoxazol were (60 - <240μg/ml). The MIC50 and MIC90 of were (<240mg/ml) in Nitrofuration, amoxycillin, nalidixic acid, co- trimoxazol and amoxyclav. It is concluded that the uro -pathogens isolated during this study, were capable to resist all antimicrobial agents traditionally used in treatment of UTIs.