epidemiology and antimicrobial susceptibility pattern of uropathogens in patients with the community- and hospital-acquired urinary tract infections at a tertiary hospital in somalia

Background: urinary tract infections (utis) are the most common infections in the community and in hospitalized patients. objectives: to investigate the epidemiology and antimicrobial susceptibility pattern of uropathogens and determine the appropriate empirical antibiotics to treat utis in the community and hospitalized patients. methods: a total of 2,485 urine cultures were performed at mogadishu somali turkish training and research hospital. through the standard kirby-bauer disk diffusion method and commercial disks, antimicrobial sensitivity and resistance were studied based on the clinical and laboratory standards institute (clsi) system using mueller-hinton agar. the identification of the microorganisms was done using eosin methylene blue agar and blood agar. results: escherichia coli was the most predominant pathogen (63.4%) in all age groups, both genders, and in the community and hospital-acquired utis, followed by klebsiella pneumonia (13.3%). ceftriaxone, trimethoprim/sulfamethoxazole, ampicillin, cefuroxime, and cefixime revealed the highest resistance level (82 -100%) against uropathogens. ciprofloxacin (67.7%) and levofloxacin (54.2%) showed increasing resistance rates against uropathogens. tigecycline, colimycin, vancomycin, and teicoplanin exhibited the most powerful sensitivity rate (100%). moreover, fosfomycin, nitrofurantoin, and amikacin manifested a significant sensitivity rate ranging from 86% - 95%. acinetobacter baumannii was the most prevalent pathogen that belonged to multidrug- and extensively drug-resistant patterns in 69.1% of the samples. escherichia coli and k. pneumonia showed similar multidrug-resistant patterns in 35.2% of the cases. conclusions: the results indicated increased trends of antimicrobial resistance rate in trimethoprim/sulfamethoxazole (85.1%) and fluoroquinolones (61%) against e. coli that was higher than the recommended local resistance rate for empirical therapy (< 20% and < 10%, respectively). according to the results, using fosfomycin and nitrofurantoin are suggested for uti empiric treatment, and other antibiotics should be prescribed carefully.