Etiology and antibiotic susceptibility patterns of community-acquired urinary tract infections in a Kuwait hospital

Objective: The aim of this study was to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from patients with community-acquired urinary tract infections (UTIs) at the Infectious Diseases Hospital, Kuwait. Materials and Methods: The study was conducted over a 7-year period. Patient information was obtained from medical record files. Antibiotic-sensitivity testing was performed by disk diffusion. E test and double disk diffusion methods were used to study the production of extended spectrum beta-lactamases. Results: Of the 14,042 urine samples processed, significant bacteriuria (>10(5) cfu/ml) was detected in 1,606 (11.4%). The majority (74.5%) of the isolates were from women while the remaining 25.5% were from men. The majority of infections (75%) were due to Enterobacteriaceae, coagulase-negative staphylococci (10.3%) and group B streptococci (8.7%). Among the gram-negative enteric bacilli high prevalence of resistance to ampicillin, amoxicillin/clavulanic acid, cephalothin, and trimethoprim/sulfamethoxazole was observed. Increasing resistance to ciprofloxacin and gentamicin was observed in E. coli isolates over the 7 years. Multiple resistance was detected in 53.8 and 41% of E. coli and Klebsiella spp. strains, respectively. No glycopeptide-resistant enterococci were isolated. Conclusion: This study revealed that Enterobacteriaceae were the predominant bacterial pathogen of community-acquired UTIs in Infectious Diseases Hospital, Kuwait. It also demonstrated an increasing resistance to ciprofloxacin, gentamicin and the production of extended spectrum beta-lactamase among UTI pathogens in the community. Copyright (C) 2004 S. Karger AG, Basel.