TY - JOUR
T1 - Age and gender-specific antibiotic resistance patterns among Bangladeshi patients with urinary tract infection caused by Escherichia coli
AU - Hossain, Ahmed
AU - Hossain, Saeem Arafat
AU - Fatema, Aneeka Nawar
AU - Wahab, Abrar
AU - Alam, Mohammad Morshad
AU - Islam, Md Nazrul
AU - Hossain, Mohammad Zakir
AU - Ahsan, Gias U.
N1 - Funding Information:
The authors would like to thank Medinova Medical Services Limited for providing us the data. We would also like to thank the five anonymous reviewers and the editor for insightful comments that improved the presentation and clarity of our manuscript.
© 2020 The Author(s).
PY - 2020/6
Y1 - 2020/6
N2 - Background: In Bangladesh, treatment for urinary tract infection has become increasingly difficult due to antibiotic resistance. In addition, the prescription of age and gender-specific drugs is still far from being practiced in Bangladesh. We are examining trends of antibiotic resistance per age and gender in patients with urinary tract infection (UTI) caused by the most frequent agent, Escherichia coli. Methods: We determined the resistance of 1663 E. coli isolates obtained from urine cultures. A sensitivity study using the Kirby-Bauer method was carried out to identify the antibiotic resistance trends. Results: Imipenem with 1.9% resistance of all isolates found to be the lowest percentage of resistance. Meropenem (2.8%), amikacin (2.8%), colistin (2.9%), and nitrofurantoin (15.8%) showed low resistance percentages. The sensitivity analysis suggests that age and gender (area under curve = 0.67) should be taken into consideration to prescribe amikacin. The increasing odds ratios (OR) by age groups suggest that amikacin is a less effective agent for older patients with UTIs. Moreover, nitrofurantoin (OR = 1.45, 95% confidence interval (CI) = 1.07–1.95) and colistin (OR = 2.09, CI = 1.13–3.76) were less effective against isolates obtained from males compared to isolates obtained from females. Meropenem was effective against bacteria obtained from all age groups and genders. On the other hand, efficacy of imipenem was lower in isolates obtained from adults older than 40 years (OR: 0.44 for < = 18 years, OR = 0.47 for 19–40 years, OR = 0.86 for 41–60 years; reference: > = 61 years). Conclusion: In Bangladesh, meropenem, imipenem, amikacin, colistin, and nitrofurantoin are suitable therapeutic alternatives against urinary tract pathogens. Among the oral agents, amikacin, colistin, and nitrofurantoin should be prescribed, taking consideration of age and gender. These results will assist physicians in prescribing effective primary care antibiotics for UTI patients and encouraging the implementation of health policies for a safe prescription of antibiotics.
AB - Background: In Bangladesh, treatment for urinary tract infection has become increasingly difficult due to antibiotic resistance. In addition, the prescription of age and gender-specific drugs is still far from being practiced in Bangladesh. We are examining trends of antibiotic resistance per age and gender in patients with urinary tract infection (UTI) caused by the most frequent agent, Escherichia coli. Methods: We determined the resistance of 1663 E. coli isolates obtained from urine cultures. A sensitivity study using the Kirby-Bauer method was carried out to identify the antibiotic resistance trends. Results: Imipenem with 1.9% resistance of all isolates found to be the lowest percentage of resistance. Meropenem (2.8%), amikacin (2.8%), colistin (2.9%), and nitrofurantoin (15.8%) showed low resistance percentages. The sensitivity analysis suggests that age and gender (area under curve = 0.67) should be taken into consideration to prescribe amikacin. The increasing odds ratios (OR) by age groups suggest that amikacin is a less effective agent for older patients with UTIs. Moreover, nitrofurantoin (OR = 1.45, 95% confidence interval (CI) = 1.07–1.95) and colistin (OR = 2.09, CI = 1.13–3.76) were less effective against isolates obtained from males compared to isolates obtained from females. Meropenem was effective against bacteria obtained from all age groups and genders. On the other hand, efficacy of imipenem was lower in isolates obtained from adults older than 40 years (OR: 0.44 for < = 18 years, OR = 0.47 for 19–40 years, OR = 0.86 for 41–60 years; reference: > = 61 years). Conclusion: In Bangladesh, meropenem, imipenem, amikacin, colistin, and nitrofurantoin are suitable therapeutic alternatives against urinary tract pathogens. Among the oral agents, amikacin, colistin, and nitrofurantoin should be prescribed, taking consideration of age and gender. These results will assist physicians in prescribing effective primary care antibiotics for UTI patients and encouraging the implementation of health policies for a safe prescription of antibiotics.
KW - Antibiotic resistance
KW - Bangladesh
KW - Clinical research
KW - Diagnostics
KW - Escherichia coli
KW - Infectious disease
KW - Primary health care
KW - Public health
KW - Urinary tract infection
KW - Urology
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U2 - 10.1016/j.heliyon.2020.e04161
DO - 10.1016/j.heliyon.2020.e04161
M3 - Article
C2 - 32548331
AN - SCOPUS:85085980750
SN - 2405-8440
VL - 6
SP - e04161
JO - Heliyon
JF - Heliyon
IS - 6
M1 - e04161
ER -
