Original Research

Antimicrobial susceptibility of bacterial uropathogens in a South African regional hospital

Alicia Naidoo, Afsana Kajee, Nomonde R. Mvelase, Khine Swe Swe-Han
African Journal of Laboratory Medicine | Vol 12, No 1 | a1920 | DOI: https://doi.org/10.4102/ajlm.v12i1.1920 | © 2023 Alicia Naidoo, Afsana Kajee, Nomonde R. Mvelase, Khine Swe Swe-Han | This work is licensed under CC Attribution 4.0
Submitted: 12 April 2022 | Published: 03 March 2023

About the author(s)

Alicia Naidoo, Department of Medical Microbiology, RK Khan Laboratory, National Health Laboratory Service, Durban, South Africa; and, Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Afsana Kajee, Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Department of Medical Microbiology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Services, Durban, South Africa
Nomonde R. Mvelase, Department of Medical Microbiology, RK Khan Laboratory, National Health Laboratory Service, Durban, South Africa; and, Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Khine Swe Swe-Han, Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Department of Medical Microbiology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Services, Durban, South Africa

Abstract

Background: Urinary tract infections are common bacterial infections affecting millions worldwide. Although treatment options for urinary tract infections are well established, with ciprofloxacin long considered one of the antibiotics of choice, increasing antibiotic resistance may delay the initiation of appropriate therapy. While this increase in antimicrobial resistance has been demonstrated in multiple studies around the world, there is a dearth of information from developing countries.

Objective: This study aimed to describe the antimicrobial susceptibility patterns of commonly isolated bacterial uropathogens in a South African hospital.

Methods: Antimicrobial susceptibility data of isolates obtained from urine specimens at the RK Khan Hospital, a regional hospital in KwaZulu-Natal, South Africa, between January 2018 and December 2020 were retrieved from the hospital’s laboratory information system and analysed to determine the differences in resistance rates between the most frequently isolated bacterial uropathogens.

Results: Of the 3048 bacterial urinary pathogens isolated between 2018 and 2020, Escherichia coli (1603; 53%) was the most common, followed by Klebsiella spp. (437; 14%). Both E. coli and Klebsiella spp. showed high rates of resistance to amoxicillin/clavulanic acid (29.8% and 42.3%) and ciprofloxacin (37.7% and 30.4%). Nitrofurantoin resistance was low among E. coli (6.2%) but high among Klebsiella spp. (61.3%).

Conclusion: E. coli and Klebsiella spp. in this study were highly resistant to amoxicillin/clavulanic acid and ciprofloxacin, two of the frequently prescribed oral treatment options.

What this study adds: This study highlights the importance of regular local antimicrobial resistance surveillance to inform appropriate empiric therapy.

 


Keywords

antimicrobial susceptibility patterns; uropathogens; urinary pathogens; antibiotic resistance; urinary oral treatment

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