﻿<?xml version="1.0" encoding="UTF-8"?>
<ArticleSet>
  <Article>
    <Journal>
      <PublisherName>Academy of Medical Sciences of I.R. Iran</PublisherName>
      <JournalTitle>Archives of Iranian Medicine</JournalTitle>
      <Issn>1029-2977</Issn>
      <Volume>24</Volume>
      <Issue>3</Issue>
      <PubDate PubStatus="ppublish">
        <Year>2021</Year>
        <Month>03</Month>
        <DAY>01</DAY>
      </PubDate>
    </Journal>
    <ArticleTitle>Antimicrobial Resistance in Hospitalized Patients with Community Acquired Urinary Tract Infection in Isfahan, Iran</ArticleTitle>
    <FirstPage>187</FirstPage>
    <LastPage>192</LastPage>
    <ELocationID EIdType="doi">10.34172/aim.2021.29</ELocationID>
    <Language>EN</Language>
    <AuthorList>
      <Author>
        <FirstName>Sayed Nassereddin</FirstName>
        <LastName>Mostafavi</LastName>
      </Author>
      <Author>
        <FirstName>Soodabeh</FirstName>
        <LastName>Rostami</LastName>
      </Author>
      <Author>
        <FirstName>Yasamin</FirstName>
        <LastName>Rezaee Nejad</LastName>
      </Author>
      <Author>
        <FirstName>Behrooz</FirstName>
        <LastName>Ataei</LastName>
      </Author>
      <Author>
        <FirstName>Sina</FirstName>
        <LastName>Mobasherizadeh</LastName>
      </Author>
      <Author>
        <FirstName>Aazam</FirstName>
        <LastName>Cheraghi</LastName>
      </Author>
      <Author>
        <FirstName>Somayeh</FirstName>
        <LastName>Haghighipour</LastName>
      </Author>
      <Author>
        <FirstName>Samereh</FirstName>
        <LastName>Nouri</LastName>
      </Author>
      <Author>
        <FirstName>Arezoo</FirstName>
        <LastName>Pourdad</LastName>
      </Author>
      <Author>
        <FirstName>Parisa</FirstName>
        <LastName>Ataabadi</LastName>
      </Author>
      <Author>
        <FirstName>Nasser</FirstName>
        <LastName>Almasi</LastName>
      </Author>
      <Author>
        <FirstName>Leila</FirstName>
        <LastName>Heidary</LastName>
      </Author>
      <Author>
        <FirstName>Kourosh</FirstName>
        <LastName>Naderi</LastName>
      </Author>
      <Author>
        <FirstName>Setareh</FirstName>
        <LastName>Korangbeheshti</LastName>
      </Author>
      <Author>
        <FirstName>Shiva</FirstName>
        <LastName>Navabi</LastName>
      </Author>
      <Author>
        <FirstName>Laleh</FirstName>
        <LastName>Masssah</LastName>
      </Author>
      <Author>
        <FirstName>Zohreh</FirstName>
        <LastName>Norouzi</LastName>
      </Author>
      <Author>
        <FirstName>Mehrnoush</FirstName>
        <LastName>Bakhtiyaritabar</LastName>
      </Author>
      <Author>
        <FirstName>Saeed</FirstName>
        <LastName>Moayednia</LastName>
      </Author>
      <Author>
        <FirstName>Dariush</FirstName>
        <LastName>Shokri</LastName>
      </Author>
      <Author>
        <FirstName>Mahin</FirstName>
        <LastName>Mikhak</LastName>
      </Author>
      <Author>
        <FirstName>Majid</FirstName>
        <LastName>Rahmani</LastName>
      </Author>
      <Author>
        <FirstName>Mohammad</FirstName>
        <LastName>Hashemi</LastName>
      </Author>
      <Author>
        <FirstName>Reza</FirstName>
        <LastName>Etminani</LastName>
      </Author>
      <Author>
        <FirstName>Nasrin</FirstName>
        <LastName>Ahmadi</LastName>
      </Author>
      <Author>
        <FirstName>Roya</FirstName>
        <LastName>Kelishadi</LastName>
      </Author>
    </AuthorList>
    <PublicationType>Journal Article</PublicationType>
    <ArticleIdList>
      <ArticleId IdType="doi">10.34172/aim.2021.29</ArticleId>
    </ArticleIdList>
    <History>
      <PubDate PubStatus="received">
        <Year>2020</Year>
        <Month>06</Month>
        <Day>02</Day>
      </PubDate>
      <PubDate PubStatus="accepted">
        <Year>2020</Year>
        <Month>10</Month>
        <Day>20</Day>
      </PubDate>
    </History>
    <Abstract>Background: Antibiotic resistance against uro-pathogens is a worldwide health concern. The aim of this study was to determine the causative bacteria and antibiotic susceptibility patterns among hospitalized patients with community acquired urinary tract infection (UTI). Methods: This cross-sectional study was performed in 2016-2018 in Isfahan, Iran. Urine samples were examined for strain identification and antimicrobial resistance pattern using standard tests. Stratification was done based on gender and age (&lt;20 and &gt;20 years) groups. Chi-square and Fisher exact tests were applied to assess differences in etiology and susceptibility rates between groups. Results: Among 1180 patients, Escherichia coli was the commonest pathogen (68.1%) followed by Enterococcus spp. (8.8%) and Klebsiella pneumonia (8.0 %). Non-E. coli pathogens were more frequent among males (41.8% versus 24.8% in females, P&lt;0.01) and in those aged under 20 years (61.0% versus 22.2% in older than 20 years, P&lt;0.01). Isolated bacteria revealed high susceptibility to imipenem (94.9%), meropenem (92.2%), and amikacin (91.9%); moderate sensitivity to gentamicin (64.4%), cefepime (52.6%) and ceftazidime (47.2%); and low susceptibility to ceftriaxone (41.8%), cefotaxime (40.0%), ciprofloxacin (38.6%) and trimethoprim-sulfamethoxazol (31.3%). The sensitivity of isolates to ceftriaxone, ceftazidime, cefepime, imipenem, meropenem, amikacin and ciprofloxacin was significantly higher in females. Compared to the older age group, uro-pathogens were more susceptible to ciprofloxacin, ceftazidime and gentamicin in patients aged under 20 years. Conclusion: We found that imipenem, meropenem and amikacin were good choices for empiric therapy of complicated or severe hospitalized patients with community acquired UTI; and gentamicin, cefepime and ceftazidime were acceptable as initial choices in non-severe infections in the area.</Abstract>
    <ObjectList>
      <Object Type="keyword">
        <Param Name="value">Antimicrobial susceptibility</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Community acquired</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Hospitalized</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Infection</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Iran</Param>
      </Object>
      <Object Type="keyword">
        <Param Name="value">Urinary tract</Param>
      </Object>
    </ObjectList>
  </Article>
</ArticleSet>