Distribution and Antibiotic Resistance Pattern of Bacteria Isolated from the Patients with Community-Acquired Urinary Tract Infections in Iran: A Cross-Sectional Study

Background: Urinary Tract Infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Multi-Drug Resistance (MDR) and Extensively-Drug Resistance (XDR) in the bacteria is an alarming problem in the world. Thus, the present study was conducted to detect the etiologic agents associated with Community-Acquired Urinary Tract Infections (CA-UTIs) and investigate the antibiotic susceptibility patterns. Methods: This study was conducted on the outpatients referred to Labbafinejad Hospital Clinic, Tehran, Iran from September 2014 to March 2015. The bacterial pathogenic diversity was identified by standard laboratory methods. The antimicrobial resistance rates were determined by Kirby-Bauer disc diffusion method. Results: A total of 303 patients were enrolled in this study, among which 204 (67.3%) of them were female and 99 (32.5%) of them were male. Escherichia coli was the dominant species (69%), followed by Enterococcus faecalis (12.8%), and Klebsiella pneumoniae (4.6%). High resistance rate was observed to nalidixic acid (73.8%), trimethoprim/Sulfamethoxazole (54.3%), ciprofloxacin (54.3%) in E. coli, and tetracycline (89.7%) in E. faecalis strains as well as high susceptibility rate to meropenem (96.6%), imipenem (95.2%), amikacin (90.4%), cefoxtin (87.6%), and nitrofurantoin (82.8%) in E. coli, and nitrofurantoin (100%) in E. faecalis strains.In addition, 43.5% of the strains were found to be Multi-Drug-Resistant (MDR). Conclusions: The results of this study showed that, E. coli was the predominant uropathogen of CA-UTIs in this geographical area. It was also found that, the empirical treatment of urinary tract infections may be difficult due to high resistance to commonly used antibiotics. Continuous monitoring of MDR organisms and drug resistance patterns is needed to prevent treatment failure and reduce selective pressure. These findings suggest the use of nitrofurantoin, cefoxitin, and amikacin in this area of the country.