Urinary Tract Infection (UTIs)s: Microflora, Microbial pathogenesis, host-pathogen interactions and new treatment strategies

Abstract

Recently, the world's problem has become in the spread of microbes and the extent of their impact on public health, especially the problem of urinary tract infections (UTIs). Urinary tract infections (UTIs) are among the most common bacterial infections and account for a significant part of the workload in clinical microbiology laboratories. Enteric bacteria (in particular, Escherichia coli) remain the most frequent cause of UTIs, although the distribution of pathogens that cause UTIs is changing.  Therefore, the purpose of the study was to clarify the extent of infection of the urinary tract and the extent of development of these microbes in resistance to antibiotics (antibiotic susceptibility pattern). Bacterial identification was based on standard culture and biochemical characteristics of isolates.Antimicrobial susceptibility was tested by the disk diffusion method. Results. E. coli was the most frequent isolate throughout the experiment. It was followed by Klebsiella pneumoniae and Proteus sp., Pseudomonas aeruginosa, Enterococcus sp., and Streptococcus agalactiae. E. coli occurred more frequently in women (69.8%) than in men (61.4%). The lowest percentage of susceptibility of E. coli was manifested against piperacillin and ampicillin. The pathogens are isolated from hospitals and private medical centers. In this study, two hundred twenty-five urine samples were collected from various sources, where 126 patients were infected with bacteria while 99 patients had no infection. In Gram-negative bacteria, the most common bacteria were E. coli (55.5%) followed by Klebsiella spp (23.0%), Proteus spp (7.14%), Pseudomonas spp (6.34%), and Acinetobacter spp (3.96%). In the Gram-positive bacteria Staphylococcus spp (2.38%) and Enterococcus spp (1.58%) were found. Antibiotic susceptibilities for Gram-negative and positive bacteria were investigated according to clinical laboratory standard institute (CLSI 2019). In Gram-negative bacteria, Amikcin, Impinem, and levofloxacin was sensitive. However, in Gram-positive bacteria, levofloxacin, ofloxacin, and linezolid was sensitive. At the same time, most of the remaining antibiotics are 100% resistant to pathogenic-bacterial isolates. This study showed bacteria that are isolated from urine which causing urinary tract infection and showed resistance to almost all antibiotics, so UTI is difficult to treat by common antibiotics.