Antimicrobial Resistance pattern in Gram-Negative Uropathogens in Duhok City, Northern Iraq

Abstract

Antimicrobial resistance (AMR) is one of the most dangerous global threats since antimicrobial discovery. The world health organization(WHO) has implemented a program called GLASS to mitigate resistance across the globe. Urinary tract infection(UTI) are the second most common infections and are the most common reason for prescription of antimicrobials, the rise in AMR has caused concerns of UTI Overuse and misuse of prescriptions and decrease of treatment options hence many researches conducted across the globe are on uropathogens resistance rate and trend. This retrospective study was conducted in duhok province of KRI to measure antimicrobial resistance percentages and identify the most common uropathogens.

309 urine samples were collected in a time span of 12 months. Urine samples were collected by clean catch midstream and inoculated on blood and MacConkey agars, Antibiotic sensitivity test (AST) was performed to identify Gram negative uropathogen and its sensitivity pattern.

We found out most common Gram negative uropathogen in females were E.coli and Klebsiella pneumonia while in males it was E.coli and Pseudomonas aeruginosa and common Klebsiella pneumonia. E.coli was most resistance to amoxicillin/amp(64.2%) and it was least resistant to carbapenems(6.1%). Klebsiella pneumonia had similar resistant pattern to E.coli. pseudomonas aeruginosa was highly resistant to all antimicrobials, third gen cephalosporins were the highest 95.7%.

AMR has risen to concerning levels in duhok and if not controlled would result in simple infections causing death in future we recommend guidelines for control of Overuse, misuse and ease of availability of antimicrobials as a measure to decrease AMR. Continues monitoring should be performed on AMR development in the future.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Study protocol was approved by the ethics committee of the college of medicine, University of Duhok.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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