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Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis
Seyed Abdol Reza Mortazavi-Tabatabaei1, Jalal Ghaderkhani2, Ali Nazari3
1Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background:
Urinary tract infection (UTI) is one of the most common infectious diseases ranking next to upper respiratory tract infections. UTIs are often significantly associated with morbidity and mortality. The inappropriate administration of antibiotics to treat these infections increased infection resistance to antibiotics. The aim of this study is to determine the frequency of antibiotic resistance pattern in UTIs.
Methods:
We searched several databases including PubMed, Web of Science, Scopus, Google Scholar, Iran Medex, Magiran, IranDoc, MedLib, and Scientific Information Database to identify the studies addressing antibacterial resistance patterns of the most common uropathogenic bacteria in UTIs in Iran. A total of 90 reports published from different regions of Iran from 1992 to May 2015 were involved in this study.
Results:
It is shown that the most common pathogen causing UTIs is Escherichia coli with 62%. The resistance among the isolates of E. coli was as follows: ampicillin (86%), amoxicillin (76%), tetracycline (71%), trimethoprim-sulfamethoxazole (64%), cephalexin (61%), and cefalothin (60%). The highest sensitivity among isolates of E. coli was as follows: imipenem (86%), nitrofurantoin (82%), amikacin (79%), chloramphenicol (72%), and ciprofloxacin (72%).
Conclusions:
The results of this study showed that the most common resistance are antibiotics that are commonly used. The most effective antibiotics for E. coli were imipenem, nitrofurantoin, amikacin, chloramphenicol, and ciprofloxacin. Considering this study, it had better, use less gentamicin, second-generation cephalosporins, and nalidixic acid in the initial treatment of infections caused by E. coli, and no use penicillins, tetracyclines, cotrimoxazole, and first-generation cephalosporins.
Insights
Antibiotic resistance is a growing concern in urinary tract infections (UTIs), particularly with common pathogens like Escherichia coli. This study highlights effective antibiotics and recommends limiting the use of certain others for better UTI treatment outcomes.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Urinary tract infections (UTIs) are a prevalent cause of morbidity and mortality.
- Inappropriate antibiotic use has led to increased antimicrobial resistance.
- Understanding resistance patterns is crucial for effective UTI management.
Purpose of the Study:
- To determine the frequency and patterns of antibiotic resistance in UTIs within Iran.
- To identify the most common uropathogenic bacteria and their susceptibility profiles.
Main Methods:
- A systematic review of 90 reports from various Iranian databases (1992-2015).
- Studies focused on antibacterial resistance patterns of common uropathogens in UTIs.
- Data extraction on bacterial prevalence and antibiotic susceptibility.
Main Results:
- Escherichia coli was the most frequent pathogen, causing 62% of UTIs.
- High resistance rates were observed for ampicillin (86%), amoxicillin (76%), and tetracycline (71%) in E. coli.
- High sensitivity was noted for imipenem (86%), nitrofurantoin (82%), and amikacin (79%) against E. coli.
Conclusions:
- Commonly used antibiotics show high resistance rates in UTIs.
- Imipenem, nitrofurantoin, amikacin, chloramphenicol, and ciprofloxacin are effective against E. coli.
- Reduced use of gentamicin, second-generation cephalosporins, nalidixic acid, and avoidance of penicillins, tetracyclines, cotrimoxazole, and first-generation cephalosporins are recommended for E. coli UTIs.
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