Prevalence and risk factors of community-acquired urinary tract infections due to ESBL-producing Gram negative bacteria in an Armed Forces Hospital in Sothern Saudi Arabia

This study investigated the prevalence and Antibiotic sensitivity profiles of Gram negative bacteria (GNB) isolated from urine specimens of out-patients with urinary tract infections (CA-UTI) in Armed Forces Hospital in southern Saudi Arabia, risk factors for infection, and extended spectrum β-lactamase production (ESBLs). The Vitek2 system (BioMe rieux, France), was used for microbial identification, susceptibility testing, and ESBL detection, which was also confirmed by the Clinical and Laboratory Standards Institute double-disk synergy test. A total of 269 GNB were studied. E. coli accounted for 77 % (206/269), Klebsiella pneumoniae for 16 % (43/269) and other GNB 7% (20/269). Fifty four % (23/43) of K. pneumoniae and 44% (91/206) of E coli isolates, were ESBL positive. Females comprised 74% (200/269) of patients, and 14% (37/269) were pregnant. Patients aged ≤10 years and those aged 7180 years showed significant high risk to CA-UTI at frequency of 20.4 % (55/269) and 24.9 %(67/269) respectively. Unlike pregnancy, diabetic, cardiac, and/or renal disease-patients showed also high risk to CA-UTI by K. pneumonia. E. coli, K. pneumoniae and other GNB susceptibility against meropenem, amikacin and gentamicin were 99%, 95 % and 85%; 88%, 88 % and 75%; and 75 %, 60 % and 70% respectively. While 53% and 25% of E coli isolates were resistant to TMP/SMZ and nitrofurantoin respectively. Seven Eterobacteriaceae isolates (E coli, 2; K pneumonia, 2; Serratia marcescens, 2 and Citrobacter freundii, 1) were resistant to all tested 14 drugs (pan-resistant isolates). Our findings identified risk factors which can be used to guide appropriate empiric therapy of CA-UTI, and targeted infection control measures.