Bacterial etiology and antimicrobial susceptibility profiles of 7741 urine cultures in outpatients: A 5-year single-center experience in Turkey

Keywords: Urinary tract infection, antibiotic resistance, uropathogens, outpatients


Aim: To determine the epidemiological and antibiotic susceptibility profile of bacterial uropathogens in outpatients.

Methods: This study analyzed data taken from outpatients with urinary tract infection (UTI) collected from January 2013 to January 2018 in the laboratory of Maltepe Medical Center in İstanbul. Species of uropathogens were made using routine laboratory methods. Antibiotic resistance profile of uropathogens was determined using disk diffusion method.

Results: There were 7741 urine cultures and 1563 of them were positive for bacterial uropathogens. The identified major organisms were Gram-negative bacteria (1376/1563; 88.0%), while Gram-positive bacteria only 5.4% (187/1563) were representing. The patients with positive samples, 84.8% (1326/1563) were female and 15.1% (237/1563) were male. The main isolated uropathogen was E. coli (58.1%), followed by Enterobacter spp (10.1%), P. mirabilis (8.6%), K. pneumoniae (7.8%), Enterococcus (4.7%) and P. aeruginosa (3.1%). E. coli was more prevalent in all age groups. A total of 74.8% of E. coli isolates were resistant to ampicillin and the lowest resistance rate was to imipenem (0.3%). Enterobacter species were found to have higher resistance to ampicillin (87.3%), lower resistance to carbapenem (1.8%) and amikacin (6.9%).

Conclusion: Due to the emergence of various antibiotics resistant bacterias, it was concluded that empirical antibiotic treatment should be reviewed periodically according to the regions. Empirical therapy must be based on local epidemiological data, which should be constantly updated. Therefore, the results of our study may help physicians to select an appropriate antimicrobial therapy.