Antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infections in a Saudi Arabian hospital.

The study describes the pathogens causing urinary tract infections (UTI) and the antimicrobial susceptibility pattern of health care-associated (HCA) and community-acquired (CA) isolates. Of the total of 3,989 nonrepetitive urinary cultures, 4.7% (n=188) were HCA and 95.3% (n=3,801) were CA isolates. Gram-negative organisms totaled 3,607 (90.4%) vs. 9.6% Gram-positive organisms. In CA-UTI, Escherichia coli, Klebsiella pneumoniae and Enterococcus faecalis constituted 66, 11.4, and 5.4%, respectively. HCA-UTI episodes were caused by E. coli (37.8%), K. pneumoniae (14.4%) and Pseudomonas aeruginosa (6.4%). The susceptibility rates of E. coli to ciprofloxacin, trimethoprim-sulfamethoxazole (TMP-SMX), nitrofurantoin and ceftriaxone in HCA and CA isolates were 53.3 and 74.1%, 42.2 and 62.7%, 32.5 and 97.0%, and 62.3 and 92.7%, respectively. Extended-spectrum beta-lactamase production was detected in 8.1 and 7.4% isolates, respectively, of CA and HCA isolates of E. coli. CA isolates of K. pneumoniae were more susceptible to TMP-SMX (89.2 vs. 60.4%), ciprofloxacin (92.6 vs. 67.9%) and cefuroxime (93.8 vs. 24.5%) than HCA isolates. The susceptibility of HCA and CA isolates of E. faecalis to penicillin G and nitrofurantoin were 34.8 and 80%, and 78.3 and 93.6%, respectively (p<0.001). In conclusion, antimicrobial resistance is high to commonly used oral agents, rendering them inappropriate for empirical use.