Causative pathogens and antibiotic resistance in community-acquired urinary tract infections in central South Africa

Background. Urinary tract infections (UTIs) are very common in community practice. Both the South African (SA) antibiotic stewardship programme (2015) and Essential Medicines List for SA (2018) recommend ciprofloxacin as first-line treatment community-acquired urinary (CAUTIs). The pathogens responsible CAUTIs their susceptibility profiles need to be documented, which is important developing updating protocols. Objectives. To determine causative of greater Bloemfontein area, central SA, review susceptibilities commonly prescribed antibiotics. Methods. Urine samples sent microscopy culture between 2011 2015 by three largest primary healthcare facilities were analysed retrospectively. Specimens with a significant count (>105 CFU/mL) single uropathogen included. These results obtained from National Health Laboratory Service data warehouse after required consent. Data regarding age, gender, pathogen cultured antimicrobial captured. All calculations carried out statistical analysis software SPSS 17.0 (SPSS Inc., USA). Results. A total 712 met inclusion criteria. Women accounted 481 (67.6%) infections. prevalence UTIs per age group was follows: 1 month - 25 years ( n =146; 20.51%); 26 50 =324; 45.5%); 51 75 =199; 27.9%). distribution did not differ groups. Escherichia coli most prevalent 410 (57.6%) specimens, followed Klebsiella spp. 97 (13.6%) Enterococcus 71 (10.0%) specimens. E. showed resistance rates 77.1% amoxicillin, 15.6% amoxicillin-clavulanate, 18.5% ciprofloxacin, 4% nitrofurantoin 11% trimethoprim-sulfamethoxazole (TMP-SMX). uropathogens different men women, lower p =0.045). Conclusions. As expected, comprised isolates, higher than expected number isolates cultured. oral antibiotics has decreased research setting, mirrors global trend. This study provides showing that TMP-SMX can used safely alternatives SA.