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Article Type

Original Study

Abstract

Objective The aim of the study was to examine the prevalence of quinolone resistance and determine appropriate empiric antibiotics for patients with urinary tract infection (UTI). Background UTI is the most common disease of the urinary tract and it is a major cause of morbidity in both hospitals and communities. Most infections arise from Escherichia coli. Quinolones are effective for treatment of UTIs. Therapy against infectious diseases with antimicrobial agents such as quinolones is very dynamic, with high probability for bacterial resistance. Patients and methods This study was carried out on 150 patients (80 patients suffering from UTI with positive bacterial growth; 55 patients with mixed growth; and 15 patients with Candida). All studied patients with positive bacterial growth were submitted to complete history taking, clinical examination, urine analysis, biochemical tests, bacterial count, urine culture, and antimicrobial sensitivity of all isolates to quinolone drugs (nalidixic acid, ciprofloxacin, levofloxacin, ofloxacin, and gatifloxacin). Results In this study 80 (53%) patients had positive urine culture (54% male and 46% female). The most commonly isolated bacterium was E. coli (52.5%). Individuals over the age of 50 years were more frequently affected by UTI. The sensitivity of male and female patients to ciprofloxacin and levofloxacin showed a highly statistically significant difference (P < 0.001) for each, and sensitivity to ofloxacin, gatifloxacin, and nalidixic acid showed a statistically significant difference (P<0.05). In catheterized patients, prevalence of infection with Enterobacter spp. and Citrobacter spp. was higher, whereas in noncatheterized patients infection with E. coli, Gram-positive cocci, and Klebsiella spp. was high. Antibiotic sensitivity of the isolated pathogens was ascertained, which showed that gatifloxacin was the most effective antibiotic against pathogens and nalidixic acid was the least effective. Conclusion UTI is a serious health problem. Random use of quinolones in UTI should be discouraged because of increased antimicrobial resistance.

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