Multidrug Resistance in Pathogens of Community-Acquired Urinary Tract Infections in Turkey: a Multicentre Prospective Observational Study

Abstract

Background/aim: To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options.Materials and methods: We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed. Results: Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advanced age, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions.Conclusion: The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factors for antibacterial resistance individually. Community-acquired UTIs should be followed up time-and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.