Analysis of bacterial resistance to antimicrobial drugs in the treatment of urinary tract infections

Introduction: Non-critical and irrational use of antibiotics is the most important reason for the ever faster development of infectious diseases causative agents’ resistance to those drugs. The aim of this study was to determine the most frequent bacterial causative agents of urinary infections and their resistance to antibiotics. Methods: The study was carried out in the Microbiological Laboratory of the Institutefor Public Health of Canton Sarajevo, during the period of January-March 2007, 2008, and 2009. The identification of the causative agents was conducted with classical biochemical series and the sensitivity test to antimicrobial drugs with the disc-diffusion method. The CLSI protocols that precisely define the kind of antibiogram discs used for particular bacteria were used. Results: The most common causative agents of urinary infections were E scherichia coli , Gr. Klebsiella-Enterobacter , Proteus mirabilis and Pseudomonas spp. The highest prevalence of the studied infections was at the age of 71-90 years for all four bacterial species. Women are more exposed to E. coli and Proteus mirabilis infections, and men to Pseudomonas spp . infections. The highest resistance of E. coli was to ampicillin and to trimethoprim+sulfomethoxazole, and the least towards cefixime. For Proteus mirabillis , there was significantly more nonresistant strains than resistant ones toall tested antibiotics except to nitrofurantoin. The least was shown in case of cefixime and gentamicin. Gr. Klebsiella-Enterobacter showed generaly high resistance towards all antibiotics, the least to gentamicin. Documented resistance of Pseudomonas spp . to all antibiotics was also very high. Key words: urine culture, antibiotics, antibiogram, sensitivity,resistance