Abstract：
BACKGROUND: Urinary tract infections (UTIs) are among the most common infections and can cause numerous complications of the renal system. This study aimed to assess the prevalence of uropathogens and their antibiotic susceptibility patterns in Al-Madinah Al-Munawarah, Saudi Arabia.
METHODS: Data was collected from patients with UTIs presented at King Fahad General Hospital in Al-Madinah Al-Munawarah, Saudi Arabia. In this retrospective cross-sectional study, UTI microbial-causing agents and antimicrobial resistance profiles identified using automated systems, Phoenix and VITEK2, were collected between July 2022 and June 2023. In addition, minimal demographic data, including date of collection and sex and age of patients were collected and analyzed using Chi-square test.
RESULTS: The study included 1394 patients positive for UTI, comprising 50.57% males and 49.43% females (chi-square goodness-of-fit, p > 0.999). Microbial identification and antimicrobial susceptibility tests were performed on UTI-positive cultures. Among UTIs, mono-infection, caused by a single pathogen, was the most prevalent, accounting for 88.16% of cases, whereas poly-infection (caused by multiple pathogens) presented at 11.9%. The most prevalent UTIs\' pathogens were E. coli (30.59%), followed by Klebsiella pneumoniae (21.40%), Enterococcus faecalis (8.46%), Pseudomonas aeruginosa (7.81%), Streptococcus agalactiae (6.35%), Enterococcus faecium (3.01%), Proteus mirabilis (3.01%), Enterobacter cloacae (2.52%), Candida sp. (2.44%), Acinetobacter calcoaceticus-baumannii (1.95%), Staphylococcus aureus (1.79%), and Enterobacter aerogenes (1.30%). The most dominant pathogens that coexisted with other uropathogens to cause UTIs were K. pneumoniae and P. mirabilis (9.32%, chi-square 5.550, p = 0.018), K. pneumoniae and P. aeruginosa (8.07%, chi-square 6.285, p = 0.012), K. pneumoniae and E. faecalis (7.45%, chi-square 5.785, p = 0.016), Candida sp. and Enterococcus faecium (4.97%, chi-square 9.176, p = 0.002, and Candida sp. and Acinetobacter calcoaceticus-baumannii (3.11%, chi-square 4.312, p=0.038)). Among the uropathogens, gram-negative pathogens showed resistance to most of the tested antimicrobials (ampicillins, cephalosporins, fluoroquinolones, trimethoprim-sulfamethoxazole, aztreonam, and nitrofurantoin). High rates of resistance were identified to cephalosporins, amoxicillin-clavulanic acid, and trimethoprim-sulfamethoxazole.
CONCLUSIONS: This study reported UT mono-infection and poly-infection in Al-Madinah Al-Munawarah, Saudi Arabia, with a predominant representation from gram-negative bacteria, Enterobacteriaceae. Most of the UT microbial strains showed a highly resistant profile.
METHODS: Data was collected from patients with UTIs presented at King Fahad General Hospital in Al-Madinah Al-Munawarah, Saudi Arabia. In this retrospective cross-sectional study, UTI microbial-causing agents and antimicrobial resistance profiles identified using automated systems, Phoenix and VITEK2, were collected between July 2022 and June 2023. In addition, minimal demographic data, including date of collection and sex and age of patients were collected and analyzed using Chi-square test.
RESULTS: The study included 1394 patients positive for UTI, comprising 50.57% males and 49.43% females (chi-square goodness-of-fit, p > 0.999). Microbial identification and antimicrobial susceptibility tests were performed on UTI-positive cultures. Among UTIs, mono-infection, caused by a single pathogen, was the most prevalent, accounting for 88.16% of cases, whereas poly-infection (caused by multiple pathogens) presented at 11.9%. The most prevalent UTIs\' pathogens were E. coli (30.59%), followed by Klebsiella pneumoniae (21.40%), Enterococcus faecalis (8.46%), Pseudomonas aeruginosa (7.81%), Streptococcus agalactiae (6.35%), Enterococcus faecium (3.01%), Proteus mirabilis (3.01%), Enterobacter cloacae (2.52%), Candida sp. (2.44%), Acinetobacter calcoaceticus-baumannii (1.95%), Staphylococcus aureus (1.79%), and Enterobacter aerogenes (1.30%). The most dominant pathogens that coexisted with other uropathogens to cause UTIs were K. pneumoniae and P. mirabilis (9.32%, chi-square 5.550, p = 0.018), K. pneumoniae and P. aeruginosa (8.07%, chi-square 6.285, p = 0.012), K. pneumoniae and E. faecalis (7.45%, chi-square 5.785, p = 0.016), Candida sp. and Enterococcus faecium (4.97%, chi-square 9.176, p = 0.002, and Candida sp. and Acinetobacter calcoaceticus-baumannii (3.11%, chi-square 4.312, p=0.038)). Among the uropathogens, gram-negative pathogens showed resistance to most of the tested antimicrobials (ampicillins, cephalosporins, fluoroquinolones, trimethoprim-sulfamethoxazole, aztreonam, and nitrofurantoin). High rates of resistance were identified to cephalosporins, amoxicillin-clavulanic acid, and trimethoprim-sulfamethoxazole.
CONCLUSIONS: This study reported UT mono-infection and poly-infection in Al-Madinah Al-Munawarah, Saudi Arabia, with a predominant representation from gram-negative bacteria, Enterobacteriaceae. Most of the UT microbial strains showed a highly resistant profile.
摘要：
背景：尿路感染（UTI）是最常见的感染之一，可引起许多肾脏系统并发症。这项研究旨在评估Al-MadinahAl-Munawarah的尿路病原体的患病率及其对抗生素的敏感性模式，沙特阿拉伯。
方法：数据来自在Al-MadinahAl-Munawarah的KingFahadGeneralHospital就诊的UTI患者，沙特阿拉伯。在这项回顾性横断面研究中，使用自动化系统确定的UTI微生物致病因子和抗菌素耐药性概况，Phoenix和VITEK2是在2022年7月至2023年6月之间收集的。此外,最少的人口统计数据，包括收集日期和患者的性别和年龄，并使用卡方检验进行分析。
结果：该研究包括1394名UTI阳性患者，包括50.57%的男性和49.43%的女性(卡方拟合优度，p>0.999)。对UTI阳性培养物进行微生物鉴定和抗菌药物敏感性试验。在UTI中，单一感染，由单一病原体引起，是最普遍的，占病例的88.16%，而多感染（由多种病原体引起）占11.9％。最普遍的UTI病原体是大肠杆菌(30.59%)，其次是肺炎克雷伯菌(21.40%),粪肠球菌(8.46%),铜绿假单胞菌(7.81%),无乳链球菌(6.35%),屎肠球菌(3.01%),奇异变形杆菌（3.01%），阴沟肠杆菌(2.52%),念珠菌sp.（2.44%），鲍曼不动杆菌(1.95%),金黄色葡萄球菌(1.79%),产气肠杆菌(1.30%)。与其他尿路病原体共存导致尿路感染的最主要病原体是肺炎克雷伯菌和奇异疟原虫(9.32%，卡方5.550，p=0.018)，肺炎克雷伯菌和铜绿假单胞菌（8.07%，卡方6.285，p=0.012)，肺炎克雷伯菌和粪肠球菌(7.45%，卡方5.785，p=0.016)，念珠菌sp.和屎肠球菌(4.97%，卡方9.176，p=0.002，念珠菌。和鲍曼不动杆菌(3.11%，卡方4.312，p=0.038))。在尿路病原体中,革兰氏阴性病原体对大多数测试的抗微生物剂(氨苄青霉素，头孢菌素,氟喹诺酮类药物,甲氧苄啶-磺胺甲恶唑,氨曲南,和呋喃妥因)。对头孢菌素的耐药率很高，阿莫西林-克拉维酸，和甲氧苄啶-磺胺甲恶唑.
结论：本研究报告了Al-MadinahAl-Munawarah的UT单感染和多感染，沙特阿拉伯,主要来自革兰氏阴性细菌，肠杆菌科。大多数UT微生物菌株表现出高度抗性。
方法：数据来自在Al-MadinahAl-Munawarah的KingFahadGeneralHospital就诊的UTI患者，沙特阿拉伯。在这项回顾性横断面研究中，使用自动化系统确定的UTI微生物致病因子和抗菌素耐药性概况，Phoenix和VITEK2是在2022年7月至2023年6月之间收集的。此外,最少的人口统计数据，包括收集日期和患者的性别和年龄，并使用卡方检验进行分析。
结果：该研究包括1394名UTI阳性患者，包括50.57%的男性和49.43%的女性(卡方拟合优度，p>0.999)。对UTI阳性培养物进行微生物鉴定和抗菌药物敏感性试验。在UTI中，单一感染，由单一病原体引起，是最普遍的，占病例的88.16%，而多感染（由多种病原体引起）占11.9％。最普遍的UTI病原体是大肠杆菌(30.59%)，其次是肺炎克雷伯菌(21.40%),粪肠球菌(8.46%),铜绿假单胞菌(7.81%),无乳链球菌(6.35%),屎肠球菌(3.01%),奇异变形杆菌（3.01%），阴沟肠杆菌(2.52%),念珠菌sp.（2.44%），鲍曼不动杆菌(1.95%),金黄色葡萄球菌(1.79%),产气肠杆菌(1.30%)。与其他尿路病原体共存导致尿路感染的最主要病原体是肺炎克雷伯菌和奇异疟原虫(9.32%，卡方5.550，p=0.018)，肺炎克雷伯菌和铜绿假单胞菌（8.07%，卡方6.285，p=0.012)，肺炎克雷伯菌和粪肠球菌(7.45%，卡方5.785，p=0.016)，念珠菌sp.和屎肠球菌(4.97%，卡方9.176，p=0.002，念珠菌。和鲍曼不动杆菌(3.11%，卡方4.312，p=0.038))。在尿路病原体中,革兰氏阴性病原体对大多数测试的抗微生物剂(氨苄青霉素，头孢菌素,氟喹诺酮类药物,甲氧苄啶-磺胺甲恶唑,氨曲南,和呋喃妥因)。对头孢菌素的耐药率很高，阿莫西林-克拉维酸，和甲氧苄啶-磺胺甲恶唑.
结论：本研究报告了Al-MadinahAl-Munawarah的UT单感染和多感染，沙特阿拉伯,主要来自革兰氏阴性细菌，肠杆菌科。大多数UT微生物菌株表现出高度抗性。
