Bacterial Strains and Antimicrobial Susceptibility Patterns in Male Urinary Tract Infections in Duhok Province, Iraq

Background: Urinary tract infection (UTI) is one of the most common infectious diseases at the community level, worldwide. Objectives: This study aimed to assess the prevalence and antimicrobial susceptibility patterns of the main pathogens responsible for male UTI in the community. Methods: Urine samples were collected from 211 subjects with UTI between January 2017 and February 2020. The samples were inoculated directly on MacConkey and Blood agar and then incubated at 37°C for 24 h. Samples with a colony count of ≥ 105 CFU/mL bacteria were considered positive. Bacterial colonies were determined by standard culture and biochemical characteristics, and their susceptibility to different antibiotics was identified by the Vitek-2 compact equipment. Results: The vast majority of the bacteria were Gram-negative (170 [80.6%]), while 41 (19.4%) of them were Gram-positive. The highest infection was by Escherichia coli (52.6%), followed by Pseudomonas aeruginosa (14.2%). Staphylococcus spp. were the most common Gram-positive bacteria (13.8%). The highest susceptibility of Escherichia coli isolates was found to imipenem (96.4%), and the highest resistance rate was to ampicillin (96.4%). Pseudomonas aeruginosa was resistant to all commonly used antibiotics, and around 86% was susceptible to ertapenem (86.7%). It was also found that Staphylococcus strains were resistant to benzylpenicillin (100%) and sensitive to linezolid (100%), tigecycline (100%), and nitrofurantoin (100%). Conclusions: E. coli isolates were the most frequent pathogens causing UTI in males, followed by P. aeruginosa and Staphylococcus spp. The vast majority of isolates were resistant to commonly prescribed antibiotics such as ampicillin, ceftriaxone, cefepime, benzylpenicillin, oxacillin, and erythromycin. This is an alarming situation, and an urgent plan to control antibacterial resistance is required in the region.