The antibiotic susceptibility patterns of uropathogens isolated in Qassim, Saudi Arabia

Antimicrobial resistance is a global health problem. The present study was carried out to determine the prevalence and antibiotic resistance of uropathogens in the outpatient departments (OPDs) at the clinics of Qassim University, Saudi Arabia.

A cross-sectional study was conducted from January to December 2016. Nonrepetitive midstream urine samples (1273) were cultured on standard culture media. Identification and susceptibility testing of causative microorganisms was performed using the fully automated VITEK 2 Compact system.

Out of the 1273 nonrepetitive urine samples, 418 (32.8%) exhibited significant growth of UTI-causing microbes, 377 (90.2%) of which were Gram-negative bacilli. The commonly isolated microorganisms were Escherichia coli (157, 37.6%), Klebsiella pneumoniae (70, 16.7%), Proteus mirabilis (17, 4.1%), Pseudomonas aeruginosa (24, 5.8%), Enterobacter cloacae (11, 2.6%), Enterococcus faecalis (12, 2.9%), and Staphylococcus aureus (14, 3.3%). Overall, drug resistance was observed in 91.3% (n=381/418) of the samples, with a majority (80%) exhibiting resistance to at least 2 drugs. Drug resistance was commonly observed against ampicillin (89.9%), oxacillin (75.6%), piperacillin (85.4%), clindamycin (56.1%), amoxicillin/clavulanic acid (74.5%) and trimethoprim/sulfamethoxazole (50.4%).

The uropathogens E. coli, K. pneumoniae and P. aeruginosa and multidrug resistance pose serious therapeutic threats in the setting of this study. A concerted and systematic effort is required to rapidly identify high-risk patients and to reduce the burden of antimicrobial resistance in this region.