Community-acquired urinary tract infections in Southern Turkey: etiology and antimicrobial resistance

In this study, we compared the distribution and antibiotic susceptibility patterns of bacterial strains isolated from patients with community-acquired urinary tract infections in Southern Turkey, Hatay, during 2004 and 2005. The majority (82.3%) of the isolates were from women while the remaining (17.7%) were from men. Of all samples tested, 49% were culture-positive with a bacterial pathogen. The most frequently isolated bacterial species were Escherichia coli (45.1%), coagulase-negative Staphylococcus (CNS) (15.5%) and Klebsiella spp. (10.9%). E. coli was more prevalent in women (p < 0.05) while Klebsiella spp., Proteus spp. and Pseudomonas spp. were found more prevalent in men (p < 0.05). Increasing resistance to gentamicin, amikacin and cefazolin, and decreased resistance to ciprofloxacin, ofloxacin, levofloxacin and cotrimoxazole were observed in E. coli isolates over the 2 years. While the lowest resistance rates for E. coli occurred in 2004 (26.0%) and 2005 (20.5%) for cefuroxime, the highest resistance rates occurred in 2004 (81.3 and 47.9%) and 2005 (61.3 and 49.6%) for ampicillin and amoxicillin-clavulanate, respectively. The results of this study stress that antibiotic usage policies, especially empirical therapies, should be based on antimicrobial resistance surveillance studies.