Antibiotic prescribing and resistance patterns among patients admitted to tertiary care hospital with Urinary tract infections at United Arab Emirates (UAE).
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Keywords
E. coli, De-escalation, ESBL, Antibiotics, UTI, Broad spectrum
Abstract
Background: Urinary tract infections (UTIs) are among the most common bacterial infections, affecting individuals across all age groups. Gram-negative bacilli, especially E. coli, account for over 80% of acute UTI cases, while other pathogens like Staphylococcus saprophyticus, Klebsiella, Proteus, Pseudomonas, and Enterobacter are less common. Objectives: This study aimed to investigate the epidemiology of uropathogens and assess antimicrobial stewardship practices in the management of urinary tract infections (UTIs) at a tertiary care hospital. Methods: This retrospective study evaluated all adult patients diagnosed with UTIs over a defined time period. Microbiological data was collected to determine the prevalence of uropathogen species. Antimicrobial utilization patterns were analyzed, focusing on initial empiric use of broad-spectrum carbapenems (meropenem) and subsequent de-escalation to more targeted therapy. Results: A total of 124 UTI cases were included in this study. The Escherichia coli was the most prevalent uropathogen, isolated in the majority of UTI cases. Female patients exhibited a higher incidence of UTIs compared to male patients. Initial empiric use of meropenem, was observed in 31.4% of cases. De-escalation of antimicrobial therapy was achieved in 62.1% of cases. A high prevalence (12/16 cases – 75%) of ESBL-producing E. coli was found, which influences empiric therapy choices and de-escalation opportunities. Conclusion: The high prevalence of ESBL-producing E. coli and the relatively high rate of broad-spectrum antibiotic prescribing demonstrated the need for continued antimicrobial stewardship efforts to optimize empiric therapy and promote de-escalation strategies.
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