Frequency and Susceptibility Pattern of Urinary Bacterial Pathogens in Patients Referred to Imam Reza Specialized Polyclinic in Arak, 2012-2013, Iran

Urinary tract infection is the most common infectious diseases. Empiric treatment of urinary infections depends on predictable levels of the causative agents of this kind of infections and awareness of antibiotic sensitivity pattern. This study was conducted to identify causative agents of urinary tract infection and to determine their susceptibility to antibiotics.

In a descriptive cross-sectional study, during August 2012 to September 2013, from all outpatients suspected of urinary tract infection, who referred to Imam Reza specialized polyclinic of Arak University of Medical Sciences, urine sample was collected for analysis and culture, of which 750 patients were culture-positive. Identification of bacteria was performed using standard tests, and their susceptibility was determined by disk diffusion method. The data were analyzed using t-test, Chi-square and Fisher’s exact test with 95% confidence interval. Significance level was considered less than 0.05.

The most frequently isolated pathogen were Escherichia coli (66.8%), Enterobacter spp. (13.1%), Nonhemolytic Streptococci (6.1%), Staphylococcus epidermidis (3.9%), and Staphylococcus saprophyticus (2.9%). The results of antibiotic resistance analysis for Escherichia coli, as the most prevalent pathogen of urinary tract infection, were as follows: co-trimoxazole (55.1%), nalidixic acid (54.9%), nitrofurantoin (2.2%), norfloxacin (36.2%), ciprofloxacin (37.2%), co-amoxiclav (86.8%), ceftizoxime (18.8%), gentamicin (30.5%), cefixime (30.5%), ceftriaxone (25.6%), ceftazidime (25.7%), and cefotaxime (37.5%).

According to the results of this study, in order to select the appropriate antibiotic for treatment of urinary tract infections, bacterial spectrum and antibiotic susceptibility of urinary pathogens should be considered.