Distribution of Bacteria according to Drug Resistance among Adult Women with Bacteriuria in Samara City
DOI:
https://doi.org/10.35516/jjps.v17i2.1734Keywords:
Bacteriuria, drug resistance, SamaraAbstract
Background: Bacteriuria is defined as the presence of bacteria in urine without the accompanying signs and symptoms of a urinary tract infection. The most common bacterium causing bacteriuria is E. coli. About 1-5% of healthy premenopausal women and 1.9-9.5% of pregnant women have bacteriuria. The most effective drugs based on urine culture results were Nitrofurantoin (98.3%), followed by Cefuroxime (89.3%) and Cotrimoxazole (20%).
Aim and objectives: To identify the distribution of bacteria according to drug resistance among adult women with bacteriuria in Samara city, Iraq, and to determine certain influencing factors.
Materials and Methods: This descriptive cross-sectional study was conducted on adult women (18-44 years) attending Samara General Hospital. Demographic information and investigation results were obtained and reported using an appropriate questionnaire. A patient with asymptomatic bacteriuria was identified when one species of bacteria grew in the urine with at least 100,000 colony-forming units (CFUs) per milliliter, regardless of the presence of pyuria, even in the absence of any UTI symptoms. Frequencies (number of cases) and percentages were used to statistically describe the data where appropriate. Comparison between the study groups was performed using the Chi-square (χ2) test. P values less than 0.05 were considered statistically significant.
Results: The frequency of bacterial growth in the sample was 19%. The highest frequency of cases was among the age group 28-37 years (22.4%). Positive cases were more prevalent among pregnant women (21.4%) than non-pregnant women (13.3%). Staphylococcus was the most frequently identified bacterium (42%), followed by E. coli (39%), Klebsiella (11%), and Streptococcus (8%). The drug with the highest sensitivity to bacterial growth was Amikacin, followed by Meropenem.
Conclusions: The frequency of bacterial growth was 19%. The most frequently isolated bacteria from the culture were Staphylococcus, followed by E. coli. The most sensitive drug was Amikacin, followed by Meropenem.
References
Das K. Textbook of Medicine: Two volume set. 6th ed. New Delhi, India: Jaypee Brothers Medical; 2017.
Sendi P., Borens O., Wahl P., Clauss M., and Uçkay I. Management of Asymptomatic Bacteriuria, Urinary Catheters and Symptomatic Urinary Tract Infections in Patients Undergoing Surgery for Joint Replacement: A Position Paper of the Expert Group “Infection” of Swiss orthopedics. Journal of Bone and Joint Infection. 2017; 2(3):154–9. Available from:
http://dx.doi.org/10.7150/jbji.20425. PMC5592375 PMID:28894690 DOI: https://doi.org/10.7150/jbji.20425
Smaill FM. and Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev. 2019; 2019(11):CD000490. doi: 10.1002/14651858.CD000490.pub4. PMID: 31765489; PMCID: PMC6953361. DOI: https://doi.org/10.1002/14651858.CD000490.pub4
Baack BN., Abad N., Yankey D., Kahn KE., Razzaghi H., Brookmeyer K., Kolis J., Wilhelm E., Nguyen KH., and Singleton JA. COVID-19 Vaccination Coverage and Intent Among Adults Aged 18-39 Years - United States, March-May 2021. MMWR Morb Mortal Wkly Rep. 2021; 70(25):928-933. doi:10.15585/mmwr.mm7025e2. PMID: 34166337; PMCID: PMC8224866 DOI: https://doi.org/10.15585/mmwr.mm7025e2
Briner M. Erik Erikson page Archived 2006-08-21 at the Wayback Machine, 1999, on Briner’s site about learning theories Archived 2006-10-07 at the Wayback Machine, Department of Mathematical Sciences.
Detweiler K., Mayers D., and Fletcher SG. Bacteruria and Urinary Tract Infections in the Elderly. Urol Clin North Am. 2015; 42(4):561-8. doi: 10.1016/j.ucl.2015.07.002. Epub 2015 Aug 19. PMID: 26475952. DOI: https://doi.org/10.1016/j.ucl.2015.07.002
Lipsky BA., Ireton RC., Fihn SD., Hackett R., and Berger RE. Diagnosis of bacteriuria in men: specimen collection and culture interpretation. J Infect Dis. 1987; 155(5):847-54. doi: 10.1093/infdis/155.5.847. PMID: 3559288. DOI: https://doi.org/10.1093/infdis/155.5.847
Soliman AA., Adel SH., and Ahmed GA. Assessment and Management of Asymptomatic Bacteriuria in Pregnancy. The Egyptian Journal of Hospital Medicine. 1982; 75(1):1982–6. DOI: https://doi.org/10.21608/ejhm.2019.29171
Nicolle LE. Asymptomatic bacteriuria: when to screen and when to treat. Infect Dis Clin North Am. 2003; 17(2):367-94. doi: 10.1016/s0891-5520(03)00008-4. PMID: 12848475. DOI: https://doi.org/10.1016/S0891-5520(03)00008-4
Turpin C., Minkah B., Danso K., and Frimpong E. Asymptomatic bacteriuria in pregnant women attending antenatal clinic at komfo anokye teaching hospital, Kumasi, Ghana. Ghana Med J. 2007; 41(1):26-9. PMID: 17622336; PMCID: PMC1890540.
Abdel-Aziz Elzayat M., Barnett-Vanes A., Dabour MF., and Cheng F. Prevalence of undiagnosed asymptomatic bacteriuria and associated risk factors during pregnancy: a cross-sectional study at two tertiary centres in Cairo, Egypt. BMJ Open. 2017; 7(3):e013198. doi: 10.1136/bmjopen-2016-013198. PMID: 28325856; PMCID: PMC5372043. DOI: https://doi.org/10.1136/bmjopen-2016-013198
Moges AF., Genetu A., and Mengistu G. Antibiotic sensitivities of common bacterial pathogens in urinary tract infections at Gondar Hospital, Ethiopia. East Afr Med J. 2002; 79(3):140-2. doi: 10.4314/eamj.v79i3.8893. Erratum in: East Afr Med J. 2002 Aug;79(8):426. PMID: 12389960. DOI: https://doi.org/10.4314/eamj.v79i3.8893
Emami A., Javanmardi F., and Pirbonyeh N. Antibiotic resistant profile of asymptomatic bacteriuria in pregnant women: a systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2020; 18(8):807-815. doi: 10.1080/14787210.2020.1759420. Epub 2020 May 4. PMID: 32321329. DOI: https://doi.org/10.1080/14787210.2020.1759420
Cheesbrough M. District laboratory practice in Tropical Countries Part 2. 2nd. New York: Cambridge University Press; 2006. DOI: https://doi.org/10.1017/CBO9780511543470
Buzayan Muna M. A study of bacteriuria during pregnancy in Benghazis women. Benghazi university. 1998.
Mwaka AD., Mayanja-Kizza H., Kigonya E., and Kaddu-Mulindwa D. Bacteriuria among adult non-pregnant women attending Mulago hospital assessment centre in Uganda. Afr Health Sci. 2011; 11(2):182-9. PMID: 21857848; PMCID: PMC3158526.
Almehdawi KA., Ramadan HA., and Faisal FI. Bacteriuria in Pregnant and Non-Pregnant Women in Benghazi A comparative Study. Ver I, editor. IOSR Journal of Pharmacy and Biological Sciences (IOSR-JPBS). 2017; 12(1):133-7. DOI: https://doi.org/10.9790/3008-120101133137
Nicolle LE. Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urol Clin North Am. 2008; 35(1):1-12.
doi: 10.1016/j.ucl.2007.09.004. PMID: 18061019. DOI: https://doi.org/10.1016/j.ucl.2007.09.004
Nicolle LE., Gupta K., Bradley SF., Colgan R., DeMuri GP., Drekonja D., Eckert LO., Geerlings SE., Köves B., Hooton TM., Juthani-Mehta M., Knight SL., Saint S., Schaeffer AJ., Trautner B., Wullt B., and Siemieniuk R. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019; 68(10):e83-e110. DOI: https://doi.org/10.1093/cid/ciz021
doi: 10.1093/cid/ciy1121. PMID: 30895288. DOI: https://doi.org/10.1093/cid/ciy1121
Colgan R., Nicolle LE., McGlone A., and Hooton TM. Asymptomatic bacteriuria in adults. Am Fam Physician. 2006; 74(6):985-90. PMID: 17002033.
Alfarouk KO., Stock CM., Taylor S., Walsh M., Muddathir AK., Verduzco D., Bashir AH., Mohammed OY., Elhassan GO., Harguindey S., Reshkin SJ., Ibrahim ME., and Rauch C. Resistance to cancer chemotherapy: failure in drug response from ADME to P-gp. Cancer Cell Int. 2015; 15:71. doi: 10.1186/s12935-015-0221-1. PMID: 26180516; PMCID: PMC4502609. DOI: https://doi.org/10.1186/s12935-015-0221-1
Antimicrobial resistance. Who.int. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
Rubin RH., Shapiro ED., Andriole VT., Davis RJ., and Stamm WE. Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration. Clin Infect Dis. 1992; 15 Suppl 1:S216-27. doi: 10.1093/clind/15.supplement1.s216. PMID: 1477233. DOI: https://doi.org/10.1093/clind/15.Supplement_1.S216
Imam TH. Bacterial Urinary Tract Infections. MSD Manual Professional Edition. Available from: https://www.merckmanuals.com/professional/genitourinary-disorders/urinary-tract- infections-utis/bacterial-urinary-tract-infections?query=urinary%20tract%20infection
Matalqah Liala M., Albals Dima, Radaideh Khaloon M., Al-Khateeb Hakam, Thabet Romany H., and Abu-Ismail Luai, Abunasser Mohammad. knowledge, Attitudes and Practice toward Antibiotic Use among Under and Post-Graduate Students at Yarmouk University in Jordan: A Descriptive Study. Jordan Journal of Pharmaceutical Sciences. 2022; 15(3), 378-389. DOI: https://doi.org/10.35516/jjps.v15i3.411
Hejaz Hatem A. Knowledge and Attitudes towards Antibiotic Usage. Jordan Journal of Pharmaceutical Sciences. 2023; 16(2), 447- 447. DOI: https://doi.org/10.35516/jjps.v16i2.1486
Biochemical Tests to Identify Bacteria. In: District Laboratory Practice in Tropical Countries. New York: Cambridge University Press; 2009, 45–58.
Harding GKM., Zhanel GG., Nicolle LE., and Cheang M. Antimicrobial treatment in diabetic women with asymptomatic bacteriuria. N Engl J Med. 2002; 347(20):1576-83. Available from:
http://dx.doi.org/10.1056/nejmoa021042 DOI: https://doi.org/10.1056/NEJMoa021042
Warren JW., Tenney JH., Hoopes JM., Muncie HL., and Anthony WC. A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J Infect Dis. 1982; 146(6):719-23. doi: 10.1093/infdis/146.6.719. PMID: 6815281. DOI: https://doi.org/10.1093/infdis/146.6.719
Performance standards for antimicrobial susceptibility testing. 27th ed CLSI supplement M100. Wayne, PA; 2017.
Mignini L., Carroli G., Abalos E., Widmer M., Amigot S., Nardin JM., Giordano D., Merialdi M., Arciero G., and Del Carmen Hourquescos M. World Health Organization Asymptomatic Bacteriuria Trial Group. Accuracy of diagnostic tests to detect asymptomatic bacteriuria during pregnancy. Obstet Gynecol. 2009; 113(2 Pt 1):346-52. doi: 10.1097/AOG.0b013e318194f109.PMID: 19155905. DOI: https://doi.org/10.1097/AOG.0b013e318194f109
Mohsin R. and Siddiqui KM. Recurrent urinary tract infections in females. J Pak Med Assoc. 2010; 60(1):55-9. PMID: 20055283.
Osungunna MO. and Adeyemi AV. Asymptomatic bacteriuria: Occurrence and antibiotic susceptibility profiles among students of a tertiary institution in Ile-Ife, Nigeria. Afr J Microbiol Res. 2016; 10(15):505-10. Available from: http://dx.doi.org/10.5897/ajmr2016.7956 DOI: https://doi.org/10.5897/AJMR2016.7956
Musili P. Prevalence of Bacteriuria and Antibiotic Sensitivity Profile of Bacterial Isolates among Sexually Active Nonpregnant Women Attending Thika Level 5 Hospital. 2019. Available from: http://ir-library.ku.ac.ke/handle/123456789/20003
Kolawole AS., Kolawole OM., Kandaki-Olukemi YT., Babatunde SK., Durowade KA., and Kolawole C. Prevalence of urinary tract infections (UTI) among patients attending Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. International Journal of Medicine and Medical Sciences. 2009; 1:163–7. Available online http://www.academicjournals.org/ijmms
Linhares IM., Giraldo PC., and Baracat EC. New findings about vaginal bacterial flora. Rev Assoc Med Bras (1992). 2010; 56(3):370-4. English, Portuguese. doi: 10.1590/s0104-42302010000300026. PMID: 20676549. DOI: https://doi.org/10.1590/S0104-42302010000300026
Al-Haddad AM. Urinary tract infection among pregnant women in Al-Mukalla district, Yemen. East Mediterr Health J. 2005; 11(3):505-10. PMID: 16602474. DOI: https://doi.org/10.26719/2005.11.3.505
Akoachere JF., Yvonne S., Akum NH., and Seraphine EN. Etiologic profile and antimicrobial susceptibility of community-acquired urinary tract infection in two Cameroonian towns. BMC Res Notes. 2012; 5:219. doi: 10.1186/1756-0500-5-219. PMID: 22564344; PMCID: PMC3528744. DOI: https://doi.org/10.1186/1756-0500-5-219
Krcmery S., Hromec J., and Demesova D. Treatment of lower urinary tract infection in pregnancy. Int J Antimicrob Agents. 2001; 17(4):279-82. doi: 10.1016/s0924-8579(00)00351-4. PMID: 11295408. DOI: https://doi.org/10.1016/S0924-8579(00)00351-4
Hazhir S. Asymptomatic bacteriuria in pregnant women. Urol J. 2007; 4(1):24-7. PMID: 17514607.
Oyagade AN. and Famurewaf O. Asymptomatic significant bacteriuria among pregnant women in ADO-EKIT Ekit Sstate, Nigeria. Nigeria African Journal of Clinical and Experimental Microbiology. 2004; 5(1). DOI: https://doi.org/10.4314/ajcem.v5i1.7361
Marques LP., Flores JT., Barros Junior Ode O., Rodrigues GB., Mourão Cde M., and Moreira RM. Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women. Braz J Infect Dis. 2012; 16(5):436-41. doi: 10.1016/j.bjid.2012.06.025. Epub 2012 Sep 10. PMID: 22975174. DOI: https://doi.org/10.1016/j.bjid.2012.06.025
Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon. 2003; 49(2):71-82. doi: 10.1067/mda.2003.8. PMID: 12601338. DOI: https://doi.org/10.1016/S0011-5029(03)90001-0
Abu Taha, A. Spectrum and Antibiotic Resistance in the Community and Hospital-Acquired Urinary Tract Infected Adults. Jordan Journal of Pharmaceutical Sciences. 2023; 16(2), 455. DOI: https://doi.org/10.35516/jjps.v16i2.1494
