title: Spectrum and patterns of antimicrobial resistance of uropathogens isolated from a sample of hospitalised Lebanese patients with urinary tract infections.
abstract: A retrospective study was carried out to assess the current distribution and antimicrobial susceptibility patterns of uropathogens isolated from patients with community-acquired (CA) or hospital-acquired (HA) urinary tract infections (UTIs) who were admitted to the largest governmental hospital in Beirut City (Lebanon) in 2009-2012. Overall, 292 uropathogens were isolated. Enterobacteriaceae constituted 81% of the isolated uropathogens, with Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis being the most reported species. Moreover, 37% of the isolated uropathogens produced extended-spectrum β-lactamases (ESBLs). ESBL-producing strains were more prevalent in CA-UTIs than in HA-UTIs. In the CA-UTI group, ESBL-producing strains were more prevalent in older patients (age >60 years), male patients and patients with diabetes mellitus, urinary catheterisation and benign prostatic hyperplasia. Uropathogens isolated from CA-UTI and HA-UTI had similar resistance patterns. The highest resistance rates were found for ampicillin, amoxicillin/clavulanic acid, trimethoprim/sulfamethoxazole and ciprofloxacin. Imipenem, nitrofurantoin and piperacillin/tazobactam showed good overall activity against the isolated uropathogens. Of the isolated non-ESBL-producing E. coli, 29% were found to be multidrug-resistant. These data suggest that there is an urgent need to implement a national policy regulating the use of antibiotics, notably in the community, in order to limit the widespread increase in antimicrobial resistance.
authors.affiliation: Beirut Arab University, Faculty of Pharmacy, Department of Pharmacy Practice, Beirut, Lebanon. Electronic address: l.soubra02@bau.edu.lb.
authors.forename: L
authors.initials: L
authors.lastname: Soubra
authors.affiliation: Lebanese American University, School of Medicine, Beirut, Lebanon.
authors.forename: S
authors.initials: S
authors.lastname: Kabbani
authors.affiliation: Beirut Arab University, Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut, Lebanon.
authors.forename: M F
authors.initials: MF
authors.lastname: Anwar
authors.affiliation: Beirut Arab University, Faculty of Pharmacy, Department of Pharmacy Practice, Beirut, Lebanon.
authors.forename: R
authors.initials: R
authors.lastname: Dbouk
keywords: Antibiotic resistance; Lebanon; Prevalence; Urinary tract infection; Uropathogens