Alternative Antimicrobials for Treating Infections Caused by Drug-Resistant Uropathogens: An In vitro Laboratory-Based and Analytical Interpretation Alwahhabi Abdulrahman M.1,*, Alqahtani Khalid M.1, Asiri Saeed A1, Alqarni Mohammed S.1, Alnaish Abdulmajeed R1, ALqahtani Abdulrahman M1, Alqahtani Hussain S1, Alqahtani Ali M1, Hamid Mohamed E.2 1Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia 2Department of Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia *Corresponding e-mail: Abdurahman5557@gmail.com
Online published on 28 February, 2019. Abstract Objectives To determine the overall in vitro resistant rates among common uropathogens in order to indicate alternative antimicrobials for consideration in the future treatment of urinary tract infection (UTI). Materials and methods Data included in this study were derived from 4 years (2013–2016) cross-sectional, a retrospective study carried out in Aseer Central Hospital, Saudi Arabia. Culture positives urine and other UT specimens (n=47193) obtained from patients suspected of having UTIs were identified and tested for antimicrobial assay using the VITEK 2 system. The analysis was done using SPSS software on culture positive samples against 39 antimicrobial agents and combinations of more than one agent. Results Of the 47193 culture positive uropathogens, 51.5% were resistant to the 39 agents, whereas 48.5% were sensitive (p=0.7969). Antimicrobials with high sensitivity to all uropathogens were linezolid (99.1%), daptomycin (98.3%), vancomycin (86.7%), ertapenem (86.3%), teicoplanin (85.5%), tigecycline (85.3%), imipenem (82.4%), meropenem (79.6%), piperacillin/tazobactam (78.6%), and colistin (76.2%). In contrast, antimicrobials with high resistance were cephalothin (91.0%), nalidixic acid (86.7%), cefuroxime (79.6%), cefazolin (76.3%), mezlocillin (76.1%), piperacillin (73.6%), ceftriaxone (72.9%), norfloxacin (72.8%), ciprofloxacin (71.7%), and cefotaxime (69.7%). Conclusions Empirically prescribed antimicrobials have displayed remarkable resistance in this survey. Information on the local antimicrobial trends is needed to plan evidence-based recommendations. Drugs such as linezolid, daptomycin, vancomycin, ertapenem, teicoplanin and tigecycline indicated good alternatives (≥ 85% sensitivity) for consideration in empirical UTI therapy. However, cephalothin, nalidixic acid, and cefuroxime revealed high resistance rates (≥ 80%). Top Keywords Urinary tract infections (UTIs), In vitro assay, Drug resistance, Aseer, Saudi Arabia. Top |