Antimicrobial susceptibility profile of community-acquired urinary tract infection in adults: A seven months prospective cross-sectional study in Dakar Town, Senegal

Abstract

Introduction: With the increasing trend of antibiotic resistance, the management of urinary tract infection (UTI) is likely to become complicated, and there is a need for continuous surveillance of antibiotic susceptibility of uropathogens.

Objective: This study aimed to assess the current antimicrobial susceptibility pattern in the common uropathogens isolated from outpatients and hospitalized (<72 h).

Subjects and methods: This was a prospective observational study examining urinary isolates from patients aged ≥18 years. Urine samples were collected from 494 consecutive outpatient adults, clinically-suspected cases of urinary tract infections. Bacterial identification and antimicrobial susceptibility testing were carried out using the VITEK^® 2 Compact kit of bioMérieux.

Results: The observed prevalence of UTI was (132/494) 26.7%, 95% CI [22.9%; 30.9%]. Among the 147 organisms isolated from 132 patients, more than 90% (133) were Gram-negative bacteria. Imipenem appeared as the most active drug, with less than 3% resistance of isolates. Amikacin and cefotaxim were in general active with susceptibility rate of 70% and 67% of isolates, respectively. However cefixim was the most active oral drug tested (61%). Trimethoprim /sulfamethoxazole, nalidixic acid and fluoroquinolons were the less active drug displaying a resistance rate of 73%, 69% and 60% respectively.

Conclusion: Trimethoprim/sulfamethoxazole, nalidixic acid and fluoroquinolons should no longer be used as empirical treatments of UTI in Dakar. Alternatives must be recommended, such as cefixim the most active oral drugs available in this country.

Keywords: Urinary tract infections; Antibiotic susceptibility; Community-acquired infections; Developing country