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Journal Article > Research

Antibiotic resistance in patients with urinary tract infections in Pakistan

Bullens M, de Cerqueira Melo A, Raziq S, Lee JS, Khalid GG, Zada A, Wailly Y, Zeshan SM, Saad NJ, Gil-Cuesta J, Williams A
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Abstract
BACKGROUND
The level of antibiotic resistance of pathogens causing uncomplicated urinary tract infections (UTIs) is increasing. The 2017-2018 GLASS (Global Antimicrobial Resistance and Use Surveillance System) report indicated >70% resistance to ceftriaxone and ciprofloxacin in Escherichia coli in Pakistan.

METHODS
A prospective study was conducted in the Médecins Sans Frontières (MSF) supported Timurgara District Hospital, Timurgara, Pakistan, from September 2017 to December 2018. Women aged 18-65 years presenting to the Emergency Department with symptoms of uncomplicated UTI (cystitis/pyelonephritis) were invited to participate. We conducted microbiological culture and sensitivity testing for samples with positive dipstick or nitrite test.

RESULTS
Of the 200 patients who participated, 109 (54.5%) were diagnosed with pyelonephritis and 91 (45.5%) with cystitis. Forty-three samples (21.5%) were culture-positive: E. coli was isolated in 27 samples, Enterococcus spp. in 7 and Klebsiella pneumoniae in 6. Overall resistance to ciprofloxacin was observed in 51.8% of E. coli isolates, and ceftriaxone resistance in 66.7% of E. coli isolates and in 33.3% of K. pneumoniae. Resistance to fosfomycin was low (one E. coli isolate).

CONCLUSIONS
This study found resistance to first- and second-line antibiotics for treating UTIs as per the MSF protocol. Heightened awareness and potential changes to local prescription practices are necessary to curb the spread of antimicrobial resistance pathogens causing UTIs.
Countries
Pakistan
Subject Area
antibiotic resistanceantimicrobial resistance
DOI
10.5588/pha.21.0071
Published Date
21-Mar-2022
PubMed ID
35317540
Languages
English
Journal
Public Health Action
Volume / Issue / Pages
Volume 12, Issue 1, Pages 48-52
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