Microbes and Infectious Diseases (Feb 2024)
Comparing antibiotic susceptibility profiles of urinary tract infection isolates in a University Hospital in Burkina Faso: Community vs. hospital profiles
Abstract
Background: The emergence of antimicrobial resistance (AMR) within bacterial pathogens necessitates a local comprehension of the epidemiological context. This information is indispensable for both clinical therapeutic determinations and the reevaluation of prevailing care protocols. This study aimed to highlight the antibiotic susceptibility profile of uropathogenic bacteria isolated within a university hospital in Burkina Faso, with a focus on enhancing probabilistic antibiotic therapy for both community and hospital-based urinary tract infections (UTIs). Methodology: Data from cytological urine analysis and antimicrobial susceptibility testing spanning 29 months (January 2017 to May 2019) was retrospectively collected and systematically analyzed. Results: In both hospital and community based UTIs, Enterobacterales dominated, constituting 79.86% (81.27% vs. 79.11%) of isolates. This was followed by non-fermentative Gram-negative bacteria at 6.60% (6.35% vs. 6.88%) and Gram-positive cocci at 6.41% (7.98% vs. 5.57%). Escherichia coli (61.37%), Klebsiella pneumoniae (10.66%), and Enterobacter spp. emerged as the predominant pathogens in the same rank regardless of the origin of the ITUs. Imipenem (97.19%), amikacin (69.26%), ceftriaxone (58.44%), and ciprofloxacin (47.60%) displayed superior susceptibility against all uropathogens. Subtle but significant variations emerged between hospital and community strains' susceptibility to various antibiotics, including amoxicillin + clavulanic acid (26.05% vs. 32.26%), Imipenem (96.43% vs. 98.59%), and ciprofloxacin (45.51% vs. 51.41%). Conclusion: Penicillins showcased diminished efficacy against uropathogens, while resistance to fluoroquinolones escalated. The combined use of aminoglycosides and third-generation cephalosporins holds promise as an optimal probabilistic therapy for UTIs. Notably, the profiles of hospital and community UTIs showed substantial similarities in terms of implicated uropathogens, yet hospital strains demonstrated higher resistance levels.
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