Prevalence and antibiotic resistance profile of UTI-causing uropathogenic bacteria in diabetics and non-diabetics at the Maternity and Children Hospital in Jeddah, Saudi Arabia.

Abstract

Introduction: One of the most prevalent and recurrent infectious diseases that can range from moderate to fatal is urinary tract infection (UTI). Broad-spectrum antibiotics are the only management strategy for UTIs in ambulators and hospital stays. Due to the ongoing emergence of antibiotic resistance among uropathogens, there is a need for proper selection of antibiotics for empirical therapy against UTIs. This study aimed to compare the etiological profiles and antibiotic susceptibility patterns between diabetic and non-diabetic UTI female patients from the Maternity and Children Hospital in Jeddah, Saudi Arabia.

Methods: Urine samples from different age categories of female UTI patients were collected from January 2021 to June 2023. The positive urine cultures with a single pathogen were selected and all bacterial isolates were identified by MALDI-TOF/MS system. Antibiotic susceptibility testing was done using VITEK-2. Our study included 2,245 female patients, of which 1825 (81%) were non-diabetic and 420 (19%) were diabetic.

Results: The results showed a significant relationship (p = 0.00063) between the average age and the number of diabetic UTI patients. Gram-negative bacilli were more dominant (84.7%, n = 1903) than gram-positive cocci (15.3%, n = 342). Escherichia coli (40.8%) was the most prevalent pathogen identified with a significant (p < 0.0001) increase in non-diabetic (45.26%) than diabetic UTI patients (21.43%). Proteus mirabilis (10.2%) and Pseudomonas aeruginosa (8.7%) followed E. coli in pathogen distribution. Among gram-positive species, Enterococcus faecalis, Staphylococcus aureus, and Staphylococcus saprophyticus were found in all age groups of diabetic and non-diabetic UTI patients. The findings showed that the most resistant bacteria from patients with non-diabetic UTIs were found to be resistant to amoxicillin (37.7%) and ampicillin (40%), while the most resistant bacteria from patients with diabetes were found to be resistant to tetracycline (43.3%) and cephalothin (43.5%). In patients with UTIs, ciprofloxacin was found to be the most effective antibiotic against all bacterial species.

Discussion: According to the results, we concluded that the UTI etiological profiles varied among different ages. Ciprofloxacin is a safe medication with optimal sensitivity that can be used to treat both gram-positive and gram-negative bacteria.