CHRONIC URINARY TRACT INFECTION: ETIOLOGICAL AGENTS AND SUSCEPTIBILITY TESTING

Abstract

Chronic Urinary Tract Infections (UTIs) are infections of the urinary tract that do not respond to treatment. They may either continue to affect your urinary tract despite getting the right treatment, or may recur after the treatment process. Although UTIs can happen to anyone at any age, they are more prevalent in women. In fact, the National Kidney and Urologic Diseases Information Clearing House estimated that one out of five young adult women suffers from recurring UTI. Therefore, the aim of this study is to strengthen the surveys of the cases of Chronic Urinary Tract Infections (UTIs). In addition, we also aim to evaluate the etiological agents of the chronic urinary tract infections; and finally, the culture characterization and antibiotic susceptibility testing of the isolated pathogenic bacteria. In order to achieve these goals, we carried out a survey of 406 patients that had chronic urinary tract infection. Also, these patients had urine sample in the Department of Microbiology at the Central Laboratory of the Ministry of Health in Amman, which is the capital of Jordan from January to September 2014. Using the urine sample, culture and biochemical test and antisera were performed. A total of 406 urine samples were tested for bacterial infection. Thus, the most commonly isolated organism was Escherichia coli (70%). β - Hemolytic Streptococcus group B (8%) and Klebsiella sp (7.6%) were reported as the next most common organisms. Of all the bacteria isolated from chronic infection, only 21% were sensitive to ampicillin, 23% to ciprofloxacin, and 18% to cotrimoxazole. The highest levels of susceptibility were observed in cephalothin (81%), Gentamicin (40 %), Augmentin (33%), Norfloxacin (28%), Nitrofurantion (23%), Lefloxacin (21%), Nalidixic acid (16%), and Imipenem (14%). Conclusion: Gram-negative agents are the most common cause of UTI. Cephalothin remains the choice among the orally administered antibiotics, which is followed by Gentamicin, Augmentin. For severe disease caused by Escherichia coli which is the most common causes of chronic UTI, it requires antibiotics such as nitrofurantion. This is followed by third generation cephalosporins, which were the most effective.