Increasing incidence of bacterial resistance to antibiotics by isolates from the urinary tract

Abstract

This is a prospective study to determine the prevalence of antibiotic resistance among organisms causing urinary tract infections in a Teaching Hospital between August 2003 and July 2004 and to compare them with an earlier study in 1993. A total of 1,104 urine samples were collected in sterile universal containers from patients attending University of Nigeria Teaching Hospital and studied. All samples showing significant bacteriuna were studied and isolates identified using standard bacteriogical methods. Antibiotic sensitivity testing was performed on sensitivity test agar (Biotec, UK) using the disc diffusion method in accordance with the National Committee for Clinical Laboratory Standards (5). The results were compared with a previous study in 1993. A total of 336 urinary isolates were identified, with the coliforms being the most predominant (51.2%), followed by Staphylococcus aureus and Proteus species (28.9% and 7.1%) respectively. Compared to the earlier study, a significant increase in the resistance of the urinary pathogens to ofloxacin, ciprofloxacin and nalidixic acid was observed, however there was a decrease in the resistance to nitrofurantoin (p<0.05) using chi-square test. The results of this study should now alert doctors about the increasing possibility of treatment failures, when ciprofloxacin, ofloxacin and nalidixic acid are used for the treatment of urinary tract infections without laboratory testing. A multi-faceted approach including continued and improved surveillance, a reduction in the unnecessary use of antibiotics and infection control are necessary.

Keywords: resistance, antibiotics, urinary tract

Nigerian Journal of Clinical Practice Vol. 8(2) 2005: 107-109