Antimicrobial Surveillance for Bacterial Uropathogens in Ha'il, Saudi Arabia: A Five-Year Multicenter Retrospective Study

Abdulrahman S Bazaid; Amir Saeed; Abdulaziz Alrashidi; Abdulkarim Alrashidi; Khalid Alshaghdali; Sahar A Hammam; Talal Alreshidi; Munif Alshammary; Abdullah Alarfaj; Rawan Thallab; Abdu Aldarhami

doi:10.2147/IDR.S299846

Antimicrobial Surveillance for Bacterial Uropathogens in Ha'il, Saudi Arabia: A Five-Year Multicenter Retrospective Study

Infect Drug Resist. 2021 Apr 16:14:1455-1465. doi: 10.2147/IDR.S299846. eCollection 2021.

Affiliations

¹ Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia.
² Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of Medical Sciences & Technology, Khartoum, Sudan.
³ Ha'il Maternity Hospital, Ha'il, Saudi Arabia.
⁴ Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
⁵ Department of Medical Microbiology, Qunfudah Faculty of Medicine, Umm Al-Qura University, Al-Qunfudah, 28814, Saudi Arabia.

Abstract

Objective: Urinary tract infections (UTIs) are among the most common infections that require antibiotic intervention. Antibiotic surveillance programs are crucial to assess resistance patterns of microorganisms associated with UTIs and to tailor antibiotic therapy accordingly. Therefore, the aim of the current study is to investigate the prevalence of uropathogens and their antimicrobial susceptibility patterns in Ha'il region.

Methods: We conducted a retrospective study in two main hospitals in Ha'il over a 5-year period (January 2015 to December 2019). Laboratory reports and clinical data of patients with a positive urine culture (≥10⁵ CFU/mL) were included in the study.

Results: A total of 428 patients were included in this study. The majority of positive cultures belonged to female patients (94.4%), adults (76.9%) and outpatients (74.3%). Generally, Escherichia coli was the most common pathogen (45%), followed by Klebsiella pneumoniae (17%) and Staphylococcus aureus (12%). Extended-spectrum β-lactamase (ESBL) strains of E. coli (15.7%) and K. pneumoniae (19.7%) showed resistance to most tested antibiotics, while almost all Gram-negative uropathogens including ESBL strains presented low resistance to cefoxitin, imipenem and meropenem. Most strains of Staphylococcus aureus and Enterococcus faecalis were resistant to trimethoprim/sulfamethoxazole including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecalis (VRE), whereas the activity of linezolid was monitored against almost all different strains of Gram-positive uropathogens.

Conclusion: This surveillance study which was conducted over a 5-year period in the Ha'il region revealed that the most common UTI-associated pathogen was E. coli. Based on the current sensitivity profiles obtained from this surveillance, carbapenems and linezolid can be considered as a first therapeutic choice treating UTIs in Ha'il caused by Gram-negative and positive uropathogens, respectively. Frequent targeted surveillance programs for antibiotic-resistant pathogens and their susceptibility profiles are crucial to enable tailored empirical treatment for patients.

Keywords: AMR; Saudi Arabia; antimicrobial resistance; drug-resistant bacteria; surveillance; uropathogens.

Grants and funding

This study was funded by the Scientific Research Deanship at the University of Ha’il, Saudi Arabia, through project reference number: BA-2021.