Evaluation of Community-acquired Lower Urinary Tract Infections

Objectives: Antibiotic resistance has become an important problem not only for the treatment of hospital-acquired infections, but also for community-acquired infections. In this study, we aimed to investigate the microbial agents isolated from community-acquired urinary tract infections (UTI), their resistance rates and antibiotics used for treatment. Materials and Methods: In this retrospective single-center cross-sectional study, microorganism distribution, antibiotic resistance rates and given antibiotics were evaluated in 179 patients diagnosed with community-acquired lower UTI in Ankara City Hospital Infectious Diseases Outpatient Clinic. Results: Escherichia coli (64.8%) and Klebsiella pneumoniae (11.2%) were the most frequently isolated agents in the urine culture of 179 patients included in the study. Extended-spectrum ß-lactamase (ESBL) type resistance was observed at the rate of 48.3% in E. coli and 60% in K. pneumoniae. For E. coli, amoxicillin-clavulanate resistance rate was 54.3%, trimethoprim sulfamethoxazole resistance rate was 37%, and ciprofloxacin resistance rate was 45.7%. Conclusion: In this study, it was determined that ESBL resistance increased to 48.3% for E. coli, which we isolated most frequently in community-acquired UTIs. This shows that oral antibiotics, which we often prefer in the treatment of UTI, are not effective in almost half of the patients. Antibiotic resistance in our country has significantly limited the treatment options even in treating community acquired infections. For this reason, we think that rational antibiotic use policies should be reviewed and urgent measures should be taken.