Etiological Spectrum and Antimicrobial Resistance among Bacterial Pathogen Association with Urinary Tract Infection in Wasit Governorate/ Iraq

Objectives: This study aimed to determine the prevalence of uropathogens that cause urinary tract infections (UTIs) in Wasit Governorate, Iraq, and evaluate their patterns of antimicrobial resistance.
Methods: The study involved the examination of 840 urine samples taken from patients visiting the Al-Karama and Al-Zahraa Teaching Hospitals in Wassit province. The samples were collected from February 2022 to March 2023. Using a VITEK 2 compact system, we identified and tested the microorganisms responsible for the infections.
Results: Of the 840 urine samples of symptomatic patients with UTI, 669 (79.6%) were found to show significant growth of UTI, among whom the females were 470 (70.2%) episodes.
E. coli was the most frequently isolated uropathogen in both sex groups (42.2%, n=284), followed by S. aureus (21.2%, n=131), E. faecalis (12.5%, n=284), other staphylococci (5.8%, n=39), Proteus (4.7%, n=32), Group B Streptococcus (3.8%, n=26), Enterobacter (2.8%, n=19), and Pseudomonas (0.7%, n=5).
Based on Gram-negative isolates (n=389), resistance rates decreased in the following order: Ampicillin 68%< Piperacillin/tazobactam 49% < Cefoxitin 47% < Ceftriaxone 32% <Trimethoprim/Sulfamethoxazole and Ceftazidime 28% <Cefepime 27% <Ciprofloxacin 25%<Nitrofurantoin 23% Levofloxacin 22%<Gentamicin 21%<Amikacin 19% <Imepenem 2% on the other hand,
In the group of Gram-positive isolates (n=280) in decreasing order were Oxacillin 33% <Tetracycline 38% <Levofloxacin 24% <Clindamycin 21%< Nitrofurantoin and Trimethoprim/sulfamet hoxazole 19%< Rifampicin 13%< Tobramycin 11%< Gentamicin 10% <Teicoplanin and Vancomycin 8%.




Conclusion: In Wassit Governorate, Iraq, the primary cause of UTIs was E. coli, with S. aureus being the second most common. Among Gram-negative uropathogens, high resistance rates were found for ampicillin, second and third-generation cephalosporins, trimethoprim/sulfamethoxazole, and quinolones. However, aminoglycosides exhibited comparatively lower resistance rates. Imipenem (for Gram-negative bacteria) and vancomycin and teicoplanin (for Gram-positive bacteria) maintained strong activity, making them suitable choices for antimicrobial treatment of complicated UTIs when other options are unavailable.