Study of the Antibiotic Resistance Pattern of Bacteria Causing Urinary Tract Infections in Al-Zahra Hospital, Isfahan

Document Type : Original Article(s)

Authors

1 Assistant Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Professor, Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/jims.v43.i821.0764

Abstract

Background: Urinary tract infections are among the most common bacterial infections in humans and can lead to serious complications if not treated properly. The increase in bacterial resistance to antibiotics has challenged the treatment of these infections. The aim of this study was to determine the common pathogens and their antibiotic resistance patterns in patients with urinary tract infections at Al-Zahra Hospital, Isfahan.
Methods: This cross-sectional analytical study was conducted on 100 hospitalized patients in different departments of Al-Zahra Hospital. The patients' urine samples were cultured and the antibiogram results were analyzed using SPSS version 25 software. Pathogens were divided into two resistant groups, including PDR, MDR, and XDR, and susceptible, based on the level of antibiotic resistance. Also, demographic and risk factors associated with antibiotic resistance were investigated.
Findings: From 100 urine cultures, 109 pathogens were isolated, including 16 PDR (14.7%), 43 MDR (39.5%), 14 XDR (12.8%), and 36 susceptible (33%). The most common pathogens were Klebsiella (33.9%), Enterococcus (19.2%), and E. coli (13.7%). Klebsiella showed the highest susceptibility to colistin (100%), followed by amikacin (56.8%), meropenem (62.2%), and tazocin (67.6%). Enterococcus was susceptible to linezolid (95.24%) and vancomycin (47.6%), while E. coli was susceptible to meropenem and tazocin (66.66%), and amikacin (66.66%).
Conclusion: Klebsiella, Enterococcus, and E. coli were the most common pathogens causing urinary tract infections in Al-Zahra Hospital, showing high resistance to common antibiotics. These findings indicated the necessity of appropriate antibiotic prescription and the implementation of infection control programs to reduce antibiotic resistance.

Highlights

Atousa Hakamifard: PubMed, Google Scholar 

Rasool Soltani: PubMed, Google Scholar

Keywords

Main Subjects

References

  1. Fatahi L, Soleymani Zar M. Evaluation of urine isolated bacteria and their antimicrobial resistance in hospitalized patients in Ahvaz Golestan Hospital in 2019 [in Persian]. Jundishapur Scientific Medical Journal 2021; 20(2): 128-39.
  2. Jarsiah P, Alizadeh A, Mehdizadeh E, Ataee R, Khanalipour N. Evaluation of Antibiotic Resistance Model of Escherichia Coli in Urine Culture Samples at Kian Hospital Lab in Tehran, 2011-2012 [in Persian]. J Mazandaran Univ Med Sci 2014; 24(111): 78-83
  3. Mancuso G, Midiri A, Gerace E, Marra M, Zummo S, Biondo C. Urinary tract infections: the current scenario and future prospects. Pathogens 2023; 12(4): 623.
  4. Tan CW, Chlebicki MP. Urinary tract infections in adults. Singapore Med J 2016; 57(9): 485
  5. Czajkowski K, BroĊ›-Konopielko M, Teliga-Czajkowska J. Urinary tract infection in women. Prz Menopauzalny 2021; 20(1): 40-7.
  6. Nicolle LE. Urinary tract infection: traditional pharmacologic therapies. Disease-a-Month 2003; 49(2): 111-28.
  7. Ronald AR, Nicolle LE, Stamm E, Krieger J, Warren J, Schaeffer A, et al. Urinary tract infection in adults: research priorities and strategies. Int J Antimicrob Agents 2001; 17(4): 343-8.
  8. Hooton TM, Besser R, Foxman B, Fritsche TR, Nicolle LE. Acute uncomplicated cystitis in an era of increasing antibiotic resistance: a proposed approach to empirical therapy. Clin Infect Dis 2004; 39(1): 75-80.
  9. Nicolle LE. Epidemiology of urinary tract infections. Clinical Microbiology Newsletter. 2002; 24(18): 135-40.
  10. Tolkoff-Rubin NE, Cotran RS, Rubin RH. Urinary tract infection, pyelonephritis, and reflux nephropathy. The Kidney, 6th ed. Philadelphia: WB Saunders; 2000.
  11. Stamm WE, Norrby SR. Urinary tract infections and pyelonephritis. Harrisons principles of internal medicine 2001; 183(Suppl 1): S1-S4.
  12. Goldman L, Schafer AI. Goldman's Cecil medicine E-book. Elsevier Health Sciences; 2011.
  13. Medina-Polo J, Naber KG, Johansen TE. Healthcare-associated urinary tract infections in urology. GMS Infect Dis 2021; 9: Doc05.
  14. Crude N, Tveten Y, Kristiansen BE. Urinary tract infections in Norway: bacterial etiology and susceptibility. A retrospective study of clinical isolates. Clin Microbiol Infect 2001; 7(10): 543-7.
  15. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Disease-a-Month 2003; 49(2): 53-70.
  16. Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Clin Infect Dis 1999; 29(4): 745-58.
  17. Talebi H R, Ayatollahi J, Akhundi Z. Examining the antibiotic resistance pattern of escherichia coli isolates obtained from patients referred to the central laboratory of Meibod City in 2021 [in Persian]. JSSU 2025; 33(1): 8625-33.
  18. Talan DA, Naber KG, Palou J, Elkharrat D. Extended-release ciprofloxacin (Cipro XR) for treatment of urinary tract infections. Int J Antimicrob Agents 2004; 23(Suppl 1): S54-66.
  19. Malani PN. Harrison’s principles of internal medicine. JAMA 2012; 308(17): 1813-4.
  20. Mahmoudi H, Alikhani MY, Arabestani M, Khosravi S. Evaluation Prevalence agents of urinary tract infection and antibiotic resistance in patients admitted to hospitals in Hamadan University of Medical Sciences 2011-12 [in Persian]. Pajouhan Sci J 2014; 12(3): 20-27.
  21. Khoshbakht R, Salimi A, Shirzad Aski H, Keshavarzi H. Antibiotic Susceptibility of Bacterial Strains Isolated From Urinary Tract Infections in Karaj, Iran. Jundishapur J Microbiol 2012; 6(1): 86-90.
  22. Jabrodini A, Heidari F, Taghavi S, Shokouh M. The investigation of frequency and antibiotic resistance pattern of escherichia coli and klebsiella pneumoniae isolated from urinary tract infection in outpatients referred to Amiralmomenin Ali Hospital in Gerash City in 2017: A short report [in Persian]. J Rafsanjan Univ Med Sci 2018; 17(1): 75-84.
  23. Rezapour M, Avazzadeh F, Javadian B. Prevalence and Antibiotic Resistance Pattern of Bacteria Isolated from Urinary Tract Infections in Amol Public Hospitals: A Brief Report [in Persian]. J Mazandaran Univ Med Sci 2022; 32(213): 159-65.
  24. Hosseini BR, Sedaghat Kermanshahi Z, Ataee N, Beihaghi M, Afzali M. Prevalence of vanA and vanB genes in vancomycin-resistant Gram-positive bacteria from ESKAPE group isolated from hospitalized patients [in Persian]. Informatics in Biology, Health, and Food 2025; 2(1): 34-45.
  25. Khanmohammadi S, Nahaei M, Ahangarzadeh Rezaee M, Sadeghi J. Frequency of vancomycin, gentamicin, erythromycin and tetracycline resistance in enterococci isolated from children’s hospital of Tabriz in 2017: A short report [in Persian]. J Rafsanjan Univ Med Sci 2018; 17(4): 385-92.
  26. Zhanel GG, Hisanaga TL, Laing NM, DeCorby MR, Nichol KA, Palatnick LP, et al. Antibiotic resistance in outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). Int J Antimicrob Agents 2005; 26(5): 380-8.
  27. Mathai D, Jones RN, Pfaller MA, America TS. Epidemiology and frequency of resistance among pathogens causing urinary tract infections in 1,510 hospitalized patients: a report from the SENTRY Antimicrobial Surveillance Program (North America). Diagn Microbiol Infect Dis 2001; 40(3): 129-36.
  28. Linhares I, Raposo T, Rodrigues A, Almeida A. Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a ten-year surveillance study. BMC Infect Dis 2013; 13: 19.
  29. Noor AF, Shams F, Munshi SK, Hassan M, Noor R. Prevalence and antibiogram profile of uropathogens isolated from hospital and community patients with urinary tract infections in Dhaka City. Journal of Bangladesh Academy of Sciences 2013; 37(1): 57-63.
Journal of Isfahan Medical School
Volume 43, Issue 821
1st Week, September
September and October 2025
Pages 764-769

Files

History

  • Receive Date: 11 August 2025
  • Accept Date: 27 August 2025

Share

How to cite

Statistics