Background: Urinary tract
infections (UTIs) are a frequent reason for consultation and lead to a
significant and sometimes inappropriate prescription of antibiotics. The latter
favors antibiotic resistance and an increase in mortality as well as the cost
of treatment. The present study aims to contribute to the fight against
antibiotic resistance of enterobacteria. Methods: This is a prospective
study from January to December, 2021 in the Microbiology laboratory of the
General Reference Hospital (GRH) of Niamey including 3369 urine samples. The
antibiotic resistance of enterobacteria was determined using the Viteck-2 method. Results: At least 280 strains of Enterobacteriaceae were isolated from the patient’s urine. Among these strains, Escherichia coli was the most predominant (74.64%), followed by Klebsiella pneumoniae (16.07%) and Enterobacter cloacae (7.14%) and other
enterobacteria 2.15%. These Enterobacteriaceae are more common in community patients than in hospitalized patients. The
average age of patients is 52 years and the age group most affected by
these enterobacteria is 46-60 years (23.33%). The female sex is the most affected sex with (51.07%)
against (48.97%) for the male sex with 1.04 as sex ratio. The hospitalization
departments most affected by these enterobacteria are Nephrology (29.23%) and
Endocrinology (21.54%). Up to 75% of the Enterobacteriaceae isolates show high resistance to ampicillin, amoxicillin-clavulanic acid,
ticarcillin, piperacillin-tazobactam, cefoxitin, cefixime, ceftazidime,
ceftriaxone, cotrimoxazole, nalidixic acid and ofloxacin. Conclusion:
The high rate of antibiotic resistance among enterobacteria in urine is of
concern. Only a few Enterobacteriaceae show low resistance to ertapenem, imipenem, amikacin, gentamicin, fosfomycin
and nitrofurantoin. Therefore, these antibiotics are recommended as first line
treatment for urinary tract infections.
References
[1]
Bryce, A., Hay, A.D., Lane, I.F., Thornton, H.V., Wootton, M. and Costelloe, C. (2016) Global Prevalence of Antibiotic Resistance in Paediatric Urinary Tract Infections Caused by Escherichia coli and Association with Routine Use of Antibiotics in Primary Care: Systematic Review and Meta-Analysis. BMJ, 352, Article No. i939. https://doi.org/10.1136/bmj.i939
[2]
Dembélé, R., Sanou, R., Traoré, O., Ouédraogo, N., Coulibaly, H., Kagambega, A.B., et al. (2022) Antibiotic Susceptibility of Enterobacterales and Cocci Uropathogens in Patients Attending Regional Hospital of Dedougou, Western Region (Burkina Faso). EC Microbiology, 18, 23-32.
[3]
Ouedraogo, S., Kpoda, D.S., Ouattara, L.P., Zongo, C., Hien, Y.E., Karfo, P., et al. (2022) Identification of Bacteria Strains Isolated in Urinary Tract Infections and Their Antibiotic Susceptibility at the National Public Health Laboratory, Ouagadougou. Open Journal of Medical Microbiology, 12, 83-95. https://doi.org/10.4236/ojmm.2022.123008
[4]
Isnard, C. (2015) Infections du tractus urinaire à pathogènes émergents. Journal des Anti-Infectieux, 17, 152-161. https://doi.org/10.1016/j.antinf.2015.10.002
[5]
World Health Organization (2014) Antimicrobial Resistance: Global Report on Surveillance. https://www.who.int/publications/i/item/9789241564748
[6]
Rakotovao-Ravahatra, Z.D., Randriatsarafara, F.M., Rasoanandrasana, S., Raverohant, L. and Rakotovao, A.L. (2017) Phénotypes de résistance des souches d’Escherichia coli responsables d’infection urinaire au laboratoire du Centre Hospitalo-Universitaire de Befelatanana Antananarivo. Pan African Medical Journal, 26, Article 166. http://www.panafrican-med-journal.com/content/article/26/166/full/
[7]
Sagna, T. (2019) Antibiotic Susceptibility of Escherichia coli and Klebsiella pneumoniae Strains, Urinary Tract Infections Cases in Bobo-Dioulasso, Burkina Faso. EC Microbiology, 15, 172-178.
[8]
Abe, I.A., Koffi, M., Sokouri, P.D., Ahouty, B.A., et al. (2019) Assessment of Drugs Pressure on Escherichia coli and Klebsiella spp. Uropathogens in Patients Attending Abobo-Avocatier Hospital, North of Abidjan (Côte d’Ivoire). African Journal of Microbiology Research, 13, 658-666. https://doi.org/10.5897/AJMR2019.9166
[9]
Flores-Mireles, A.L., Walker, J.N., Caparon, M. and Hultgren, S.J. (2015) Urinary Tract Infections: Epidemiology, Mechanisms of Infection and Treatment Options. Nature Reviews Microbiology, 13, 269-284. https://doi.org/10.1038/nrmicro3432
[10]
Sorlózano-Puerto, A., Gómez-Luque, J.M., de Dios Luna-del-Castillo, J.D., Navarro-Marí, J.M. and Gutiérrez-Fernández, J. (2017) Etiological and Resistance Profile of Bacteria Involved in Urinary Tract Infections in Young Children. BioMed Research International, 2017, Article ID: 4909452. https://doi.org/10.1155/2017/4909452
[11]
Al-Naqshbandi, A.A., Chawsheen, M.A. and Abdulqader, H.H. (2019) Prevalence and Antimicrobial Susceptibility of Bacterial Pathogens Isolated from Urine Specimens Received in Rizgary Hospital—Erbil. Journal of Infection and Public Health, 12, 330-336. https://doi.org/10.1016/j.jiph.2018.11.005
[12]
Gajdács, M., ábrók, M., Lázár, A. and Burián, K. (2019) Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study. Medicina, 55, Article No. 356. https://doi.org/10.3390/medicina55070356
[13]
Mazzariol, A., Bazaj, A. and Cornaglia, G. (2017) Multi-Drug-Resistant Gram-Nega tive Bacteria Causing Urinary Tract Infections: A Review. Journal of Chemotherapy, 29, 2-9. https://doi.org/10.1080/1120009X.2017.1380395
[14]
Sbiti, M., Lahmadi, K. and Louzi, L. (2017) Profil épidémiologique des entérobactéries uropathogènes productrices de bêta-lactamases à spectre élargi. Pan African Medical Journal, 28, Article 29. http://www.panafrican-med-journal.com/content/article/28/29/full/
[15]
Raeispour, M. and Ranjbar, R. (2018) Antibiotic Resistance, Virulence Factors and Genotyping of Uropathogenic Escherichia coli Strains. Antimicrobial Resistance & Infection Control, 7, Article No. 118. https://doi.org/10.1186/s13756-018-0411-4
[16]
Azimirad, M., Tajbakhsh, M., Yadegar, A. and Zali, M.R. (2021) Recurrent Urinary Tract Infection with Antibiotic-Resistant Klebsiella pneumoniae in a Patient with Crohn’s Disease: A Case Report. Clinical Case Reports, 9, e04531. https://doi.org/10.1002/ccr3.4531
[17]
Merzougui, L., Barhoumi, T., Guizani, T., Barhoumi, H., Hannachi, H., Turki, E., et al. (2018) Les infections nosocomiales en milieu de réanimation: incidence annuelle et aspects cliniques au Service de Réanimation Polyvalente, Kairouan, Tunisie, 2014. Pan African Medical Journal, 30, Article 143. http://www.panafrican-med-journal.com/content/article/30/143/full/
[18]
Kot, B. (2019) Antibiotic Resistance among Uropathogenic Escherichia coli. Polish Journal of Microbiology, 68, 403-415. https://doi.org/10.33073/pjm-2019-048
[19]
Nirwati, H., Sinanjung, K., Fahrunissa, F., Wijaya, F., Napitupulu, S., Hati, V.P., et al. (2019) Biofilm Formation and Antibiotic Resistance of Klebsiella pneumoniae Isolated from Clinical Samples in a Tertiary Care Hospital, Klaten, Indonesia. BMC Proceedings, 13, Article No. 20. https://doi.org/10.1186/s12919-019-0176-7
[20]
World Health Organization (2018) High Levels of Antibiotic Resistance Found Worldwide, New Data Shows. https://www.who.int/fr/news/item/29-01-2018-high-levels-of-antibiotic-resistance-found-worldwide-new-data-shows
[21]
World Health Organization (2020) Antibiotic Resistance. https://www.who.int/fr/news-room/fact-sheets/detail/antibiotic-resistance
[22]
Çağ, Y., Haclseyitoğlu, D., Avar Özdemir, A. and Çağ, Y. (2021) Antibiotic Resistance and Bacteria in Urinary Tract Infections in Pediatric Patients. Medeniyet Medical Journal, 36, 217-224. https://doi.org/10.5222/MMJ.2021.78535 https://medeniyetmedicaljournal.org/jvi.aspx?pdir=medeniyet&plng=eng&un=MEDJ-78535
[23]
Garba, A.A., Doutchi, M., Maman, L., Hassan, D., Aboubacar, I., Alkassoum, I., et al. (2020) Etude Bactériologique des Infections Urinaires chez l’Adulte au Laboratoire de Microbiologie de l’Hopital National de Zinder. Health Sciences and Diseases, 21, 53-56. https://www.hsd-fmsb.org
[24]
Torres-Sangiao, E., Lamas Rodriguez, B., Cea Pájaro, M., Carracedo Montero, R., Parajó Pazos, N. and García-Riestra, C. (2022) Direct Urine Resistance Detection Using VITEK 2. Antibiotics, 11, Article No. 663. https://doi.org/10.3390/antibiotics11050663
[25]
Haindongo, E.H., Funtua, B., Singu, B., Hedimbi, M., Kalemeera, F., Hamman, J., et al. (2022) Antimicrobial Resistance among Bacteria Isolated from Urinary Tract Infections in Females in Namibia, 2016-2017. Antimicrobial Resistance & Infection Control, 11, Article No. 33. https://doi.org/10.1186/s13756-022-01066-2
[26]
Thibaut, S., Coeffic, T., Boutoille, D., Lemenand, O., Birgand, G., Caillon, J., et al. (2020) Résistance aux antibiotiques des Entérobactéries urinaires isolées chez les patients vivant en établissements d’hébergement pour personnes agées dépendantes (Ehpad). Médecine et Maladies Infectieuses, 50, S35. https://doi.org/10.1016/j.medmal.2020.06.058
[27]
Alamri, A., Hamid, M., Abid, M., Alwahhabi, A., Alqahtani, K., Alqarni, M., et al. (2018) Trend Analysis of Bacterial Uropathogens and Their Susceptibility Pattern: A 4-Year (2013-2016) Study from Aseer Region, Saudi Arabia. Urology Annals, 10, 41-46. https://doi.org/10.4103/UA.UA_68_17
[28]
Rafalskiy, V., Pushkar, D., Yakovlev, S., Epstein, O., Putilovskiy, M., Tarasov, S., et al. (2020) Distribution and Antibiotic Resistance Profile of Key Gram-Negative Bacteria That Cause Community-Onset Urinary Tract Infections in the Russian Federation: RESOURCE Multicentre Surveillance 2017 Study. Journal of Global Antimicrobial Resistance, 21, 188-194. https://doi.org/10.1016/j.jgar.2019.09.008
[29]
Sierra-Díaz, E., Hernández-Ríos, C.J. and Bravo-Cuellar, A. (2019) Antibiotic Resistance: Microbiological Profile of Urinary Tract Infections in Mexico. Cirugia y Cirujanos, 87, 176-182. https://doi.org/10.24875/CIRU.18000494
[30]
Pourakbari, B., Mamishi, S., Shokrollahi, M.R., Heydari, H., Mahmoudi, S., Banar, M., et al. (2019) Molecular Characteristics and Antibiotic Resistance Profiles of Escherichia coli Strains Isolated from Urinary Tract Infections in Children Admitted to Children’S Referral Hospital of Qom, Iran. Annali di igiene: Medicina preventiva e di comunita, 31, 252-262.
[31]
Rizwan, M., Akhtar, M., Najmi, A. and Singh, K. (2018) Escherichia coli and Klebsiella pneumoniae Sensitivity/Resistance Pattern towards Antimicrobial Agents in Primary and Simple Urinary Tract Infection Patients Visiting University Hospital of Jamia Hamdard New Delhi. Drug Research, 68, 415-420. https://doi.org/10.1055/a-0576-0079
[32]
Datok, D.W., Ishaleku, D., Tsaku, P.A., Agya, E.O. and Adoga, M.P. (2021) Multidrug Resistance to Commonly Prescribed Antibiotics in Escherichia coli Isolated from Barbecued Beef (Suya) Sold in a Nigerian City. Pan African Medical Journal, 39, Article 50. https://www.panafrican-med-journal.com/content/article/39/50/full
[33]
Paitan, Y. (2018) Current Trends in Antimicrobial Resistance of Escherichia coli. In: Frankel, G. and Ron, E., Eds., Escherichia coli, a Versatile Pathogen. Current Topics in Microbiology and Immunology, Vol. 416, Springer, Cham, 181-211. http://link.springer.com/10.1007/82_2018_110
[34]
Islam, M.R., Hoque, M.J., Uddin, M.N., Dewan, A., Haque, N.B., Islam, M.T., et al. (2022) Antimicrobial Resistance of E. coli Causing Urinary Tract Infection in Bangladesh. Mymensingh Medical Journal, 31, 180-185.
[35]
Hamamouchi, J., Qasmaoui, A., Halout, K., Charof, R. and Ohmani, F. (2021) Antibiotic Resistance in Uropathogenic Enterobacteria. In: Bourekkadi, S., Hami, H., Mokhtari, A., Slimani, K., Soulaymani, A. Eds., E3S Web of Conferences, Vol. 319, EDP Sciences, Les Ulis, Article No. 01102. https://doi.org/10.1051/e3sconf/202131901102
[36]
Michno, M., Sydor, A., Wałaszek, M. and Sułowicz, W. (2018) Microbiology and Drug Resistance of Pathogens in Patients Hospitalized at the Nephrology Department in the South of Poland. Polish Journal of Microbiology, 67, 517-524. https://doi.org/10.21307/pjm-2018-061
[37]
Makanéra, A., Camara, T., Diallo, A.S., Chamassi, R.M., Condé, M., Diallo, M.A., et al. (2021) Antibiotic Sensitivity Profile of Uropathogenic Escherichia coli Strains at the China-Guinea Friendship Hospital of Kipé in Conakry (Guinea). World Journal of Advanced Research and Reviews, 9, 75-85. https://doi.org/10.30574/wjarr.2021.9.1.0492
[38]
Sidibe-Koïta, M., Traore, A.M., Maïga, A., Minta, D.K., Toure-Kane, C.N., et al. (2019) Molecular Aspects of Resistance to Antibiotic of Community Escherichia coli Uropathogenic Strains in Bamako. Microbiology & Infectious Diseases, 3, 1-5. https://doi.org/10.33425/2639-9458.1073 http://scivisionpub.com/pdfs/molecular-aspects-of-resistance-to-antibiotic-of-community-escherichia-coli-uropathogenic-strains-in-bamako-991.pdf
[39]
Mouanga Ndzime, Y., Onanga, R., Kassa Kassa, R.F., Bignoumba, M., Mbehang Nguema, P.P., Gafou, A., et al. (2021) Epidemiology of Community Origin Escherichia coli and Klebsiella pneumoniae Uropathogenic Strains Resistant to Antibiotics in Franceville, Gabon. Infection and Drug Resistance, 14, 585-594. https://doi.org/10.2147/IDR.S296054
[40]
Ahmed, N., Zeshan, B., Naveed, M. Afzal, M. and Mohamed, M. (2019) Antibiotic Resistance Profile in Relation to Virulence Genes fimH, hlyA and usp of Uropathogenic E. coli Isolates in Lahore, Pakistan. Tropical Biomedicine, 36, 559-568.
[41]
Regasa Dadi, B., Abebe, T., Zhang, L., Mihret, A., Abebe, W. and Amogne, W. (2018) Drug Resistance and Plasmid Profile of Uropathogenic Escherichia coli among Urinary Tract Infection Patients in Addis Abeba. The Journal of Infection in Developing Countries, 12, 608-615. https://doi.org/10.3855/jidc.9916
[42]
Ali, I., Shabbir, M. and Iman, N.U. (2017) Antibiotics Susceptibility Patterns of Uropathogenic E. coli with Special Reference to Fluoroquinolones in Different Age and Gender Groups. Journal of the Pakistan Medical Association, 67, 1161-1165.
[43]
Cottell, J.L. and Webber, M.A. (2019) Experiences in Fosfomycin Susceptibility Testing and Resistance Mechanism Determination in Escherichia coli from Urinary Tract Infections in the UK. Journal of Medical Microbiology, 68, 161-168. https://doi.org/10.1099/jmm.0.000901
[44]
Cattoir, V., Pourbaix, A., Magnan, M., Chau, F., de Lastours, V., Felden, B., et al. (2020) Novel Chromosomal Mutations Responsible for Fosfomycin Resistance in Escherichia coli. Frontiers in Microbiology, 11, Article 575031. https://doi.org/10.3389/fmicb.2020.575031
[45]
Munkhdelger, Y., Gunregjav, N., Dorjpurev, A., Juniichiro, N. and Sarantuya, J. (2017) Detection of Virulence Genes, Phylogenetic Group and Antibiotic Resistance of Uropathogenic Escherichia coli in Mongolia. The Journal of Infection in Developing Countries, 11, 51-57. https://doi.org/10.3855/jidc.7903
[46]
Jiménez-Guerra, G., Heras-Cañas, V., Béjar Molina, L.D.C., Sorlózano-Puerto, A., Navarro-Marí, J.M. and Gutiérrez-Fernández, J. (2018) Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae from Urinary Tract Infections: Evolution of Antimicrobial Resistance and Treatment Options. Medicina Clínica, 150, 262-265. https://doi.org/10.1016/j.medcle.2018.01.014
