Transcript Antimicrobial resistance among bacterial pathogens

Antimicrobial resistance
among bacterial
pathogens isolated from
UTIs
Adham Abu Taha, PhD
Dept. of Pharmacology and Toxicology, College of Pharmacy,
An-Najah National University, Nablus, Palestine
Introduction
 Among the 10 leading causes of death,
infections are considered the number
one in the low income countries and the
fourth killer in the developed countries.
 Most of the infections are caused by
bacteria
 Antibiotics are the only drugs for these
bacterial diseases
• Urinary Tract Infection (UTI) is the most
common infectious diseases diagnosed in
outpatients.
• Reporting of antimicrobial susceptibility
testing is usually achieved in 48 h.
• The treatment decision is empirical, being
influenced by available data reflecting
antibiotic resistance.
• Knowledge of the antimicrobial resistance
patterns of common uropathogens is
essential to provide clinically appropriate
and cost effective therapy.
Aims of study
1. To determine the frequency of the
uropathogens
2. To determine the susceptibility of these
isolates to commonly used and newer
antimicrobial agents.
• A prospective study was conducted on bacteria
isolated from the urine of patients with UTI in the
city of Nablus, Palestine.
Results
Specimens: 375
Males: 69
Females: 306
Males
18.4%
Females
81.6 %
Which Bacteria ?
Frequency of uropathogens
Gram negative
Microorganism
E. coli
Pseudomonas aeruginosa
Proteus mirabilis
Klebsiella spp.
Enterobacter spp.
Number
243
51
27
12
15
%
64.8
14.4
5.6
3.2
2.4
Gram positive
S. aureus
S.saprophyticus
Enterococcus spp.
12
21
3
3.2
5.6
0.8
Total number
375
100
Distribution of uropathogens
Gender
Microorganism
E. coli
Klebsiella spp.
Pseudomonas
Enterobacter spp.
Proteus mirabilis
S. aureus
Enterococcus
S.saprophyticus
Females
n=306
Males
n=69
192 (62.7%)
12 (3.9%)
48 (15.7%)
9 (2.9%)
18 (5.9%)
6 (2.0%)
3 (1%)
18 (5.9%)
51(73.9%)
0
6 (8.7%)
0
3 (4.3%)
6 (8.7%(
0
3 (4.3%)
Antibiotics resistance of E. coli
Antibiotic
Resistance (%)
TMP-SXT
37
F
29.6
AMP
65.4
NA
37
CIP
17.2
AMC
12.3
CTX
11.1
CRO
11.1
TE
55.6
CN
14.8
ampicillin (AMP), Amoxicillin-clavulinic acid (AMC), trimethoprim-sulfamthoxazole
(TMP-SXT), nitofurantoin (F), ciprofloxacin (CIP), gentamycin (CN), cefataxime
(CTX), ceftriaxone (CRO), naladixic acid (NA), and tetracycline (TE)
Antimicrobial resistance (%) of E. coli
in selected countries
Nablus S. Gaza 1 Turkey 2 Israel 3
AMP
TMP-SXT
F
CIP
1
2
3
4
65.4
37
29.6
17.2
ND
71.4
7.1
15.0
49.1
41.5
8.8
24.5
ND
26
1
ND
USA 4
37
16.1
0.7
2.5
Astal, et al, J Biomed Biotechnol. 2005; 2005(3): 238–241
Kurtuepe et al, Jpn. Jornal of infect. Dis 58, 159 – 161, 2005
Colodher et al, I. J. of Antimicrobial agents, 8 , 189 – 192, (2001)
Karl Lowsky et al, Antimicrobial agents and chemotherapy, 2540n- 2545, (2002)
Ampicillin (AMP), trimethoprim-sulfamthoxazole (TMP-SXT),
nitrofurantoin (F), ciprofloxacin (CIP), not done (ND)
Antibiotic use in Palestine
Antibiotics were the most
commonly prescribed medications
Types of stored medications Palestinian households
Drug Classification (ATC system)
Total
%
Alimentary tract and metabolism
N=5505
1020
18.53
Musculoskeletal system
783
14.2
Respiratory system
749
13.6
Anti-infective agents for systemic use
641
11.6
Nervous system
Dermatologicals
Cardiovascular system
Blood and blood forming organs
Sensory organs
Genito urinary system and sex hormones
632
477
410
267
265
96
11.5
8.7
7.4
4.9
4.8
1.7
Int J Clin Pharmacol Ther. 2010 Jan;48(1):59-67.
Storage, utilization and cost of drug products in Palestinian households.
Sweileh WM, Sawalha AF, Zyoud SH, Al-Jabi SW, Bani Shamseh FF, Khalaf HS.
Spread of antibiotic resistance
Recommendations
1. Surveillance program of antibiotic
resistance
2. Local guidelines
3. Responsible use of antibiotics
Acknowledgment
• Mr. Jum’a Hashash- Nablus medical supplies
• Mr. Fadi Sulieman
Help prevent
antibiotic
resistance
Thank You