Antimicrobial susceptibility of bacteria isolated from urine cultures in Southern Turkey

Pathogen spectrum and antibiotic susceptibility patterns vary in different regions and should consider the empirical treatment of urinary tract infections (UTIs). Information on susceptibility is the basis for providing reliable treatment. This study aimed to determine the antibiotic susceptibility of bacteria isolated from urine cultures at Çukurova State Hospital, which is located south of Turkey and east of the Mediterranean region.

Urine culture results were retrospectively evaluated between April 2018 and January 2021. Variables, such as age, sex, and medical department, were also recorded. Inclusion criteria were patients aged at least 18 years with pathogenic bacterial growth in their urine cultures. Antibiotic susceptibility testing and bacterial identification were performed using the VITEK 2 automated system.

Of 12,288 urine samples, 2033 (16.5%) had pathogenic growth. The rates of bacterial and yeast growth were 93.3% and 6.7%, respectively. Gram-negative pathogens constituted 91.6% of the cohort. The most prevalent bacteria were Escherichia coli with a 66% rate, followed by Klebsiella (14.2%). According to our results, ciprofloxacin, trimethoprim-sulfamethoxazole, and ampicillin are not suitable for empirical treatment of UTIs, whereas nitrofurantoin and fosfomycin are rational options.

Uropathogens exhibit an increased resistance rate against ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin. Nitrofurantoin, fosfomycin, and ceftazidime have better efficacy than other investigated antibiotics in urine culture against common uropathogens and are suitable for empirical treatment of UTI.