Antibiotic senstivity of urinary tract isolates from outpatients in the Sirte region, Libya, 20052008
Abstract number: P1880
Abddulsalam Bagar S., Abdallah B., Tayar M.
Objectives: To document the incidence of resistance against commonly used antimicrobials in uropathogens isolated from outpatients in Sirte, Libya.
Methods: Six thousand nine hundred and thirty-one consecutive urine samples were collected from patients with symptoms suggestive of urinary tract infections at the New Central Polyclinic in Sirte, Libya from 2005 to 2008. Samples were cultured on MacConkey Agar with crystal violet and pure isolates with colony counts of 104 or above were identified and tested for antimicrobial resistance by the Kirby-Bauer method.
Results: One thousand six hundred and ninety-nine cultures were positive. Escherichia coli was isolated from 1265 female and 301 male patients, Klebsiella spp. was isolated from 81 female and 18 male patients, Pseudomonas aeruginosa was isolated from 16 female and 9 male patients and Proteus spp. was isolated from 7 female and 2 male patients. In E. coli, the highest resistance rates (20 to 70%) were seen against Ampicillin, Co-trimoxazole, Doxycycline, Chloramphenicol, and Nalidixic acid, with little difference across age and sex groups. Resistance rates against 1st generation cephalosporins, Gentamicin and Nitrofurantoin were 78% among infants but increased to around 20% with age and there was little difference between the sexes. Resistance against Amoxycillinclavulanate and Amikacin was absent among infants but rose with age to reach levels of 13% and 14% respectively in men above the age of 50 years. Resistance to Ciprofloxacin was absent among infants and increased with age up to 5%. Only 25% of E. coli isolates were simultaneously sensitive to the older antimicrobials (Ampicillin, Co-trimoxazole, Doxycycline, Chloramphenicol, Nalidixic acid, 1st generation cephalosporins, Gentamicin and Nitrofurantoin) but no isolate was simultaneously resistant to all of them.
Conclusion: Given the high rates of resistance to commonly used antimicrobials such as Ampicillin, Co-trimoxazole, Doxycycline, Chloramphenicol, Nalidixic acid, and even 1st generation cephalosporins and Gentamicin, one cannot recommend their use for severely ill patients without a sensitivity test report. Among the orally active antimicrobials, Nitrofurantoin remains a fair choice for lower urinary tract infections in an outpatient setting without sensitivity testing. Ciprofloxacin showed even lower resistance rates but its use should be restricted to preserve the general utility of all fluoroquinolones.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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