Antimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa

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dc.contributor.authorLewis, David A
dc.contributor.authorGumede, Lindy Y E
dc.contributor.authorVan der Hoven, Louis A
dc.contributor.authorDe Gita, Gloria N
dc.contributor.authorDe Kock, Elsabe J E
dc.contributor.authorDe Lange, Telsa
dc.contributor.authorMaseko, Venessa
dc.contributor.authorKekana, Valentia
dc.contributor.authorSmuts, Francois P
dc.contributor.authorPerovic, Olga
dc.date.accessioned2021-10-08T07:18:02Z
dc.date.available2021-10-08T07:18:02Z
dc.date.issued2013
dc.description.abstractBACKGROUND: Patients with community-acquired urinary tract infections (UTIs) frequently present to healthcare facilities in South Africa (SA). AIM: To provide information on UTI aetiology and antimicrobial susceptibility of pathogens. METHODS: We recruited women with UTI-related symptoms, who tested positive for ≥2 urine dipstick criteria (proteinuria, blood, leucocytes or nitrites) at 1 public and 5 private primary healthcare facilities in 2011. Demographic and clinical data were recorded and mid-stream urine (MSU) specimens were cultured. UTI pathogens were Gram-stained and identified to species level. Etest-based antimicrobial susceptibility testing was performed for amoxicillin/clavulanic acid, cefixime, cefuroxime, ciprofloxacin, fosfomycin, levofloxacin, nitrofurantoin, norfloxacin and trimethoprim/sulphamethoxazole. RESULTS: Of the 460 women recruited, 425 MSU samples were processed and 204 UTI pathogens were identified in 201 samples. Most pathogens were Gram-negative bacilli (GNB) (182; 89.2%) and 22 (10.8%) were Gram-positive cocci (GPC). Escherichia coli was the most frequent GNB (160; 79.6%), while Enterococcus faecalis was the predominant GPC (8; 4.0%). The UTI pathogens had similar susceptibility profiles for fosfomycin (95.5%; 95% confidence interval (CI) 92.6 - 98.4), the 3 fluoroquinolones (94.1%; 95% CI 90.8 - 97.4), nitrofurantoin (91.7%; 95% CI 87.8 - 95.6), cefuroxime (90.1%; 95% CI 86.0 - 94.3) and cefixime (88.2%; 95% CI 83.7 - 92.6). UTI pathogens were less susceptible to amoxicillin/clavulanic acid (82.8%; 95% CI 77.5 - 88.0) when compared with fluoroquinolones and fosfomycin. Trimethoprim/ sulphamethoxazole was the least efficacious antimicrobial agent (44.3% susceptible; 95% CI 37.4 - 51.2). CONCLUSION: This study provides relevant data for the empirical treatment of community-acquired UTIs in SA.
dc.identifier.apacitationLewis, D. A., Gumede, L. Y. E., Van der Hoven, L. A., De Gita, G. N., De Kock, E. J. E., De Lange, T., ... Perovic, O. (2013). Antimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa. <i>South African Medical Journal</i>, 103(6), 377 - 177. http://hdl.handle.net/11427/34890en_ZA
dc.identifier.chicagocitationLewis, David A, Lindy Y E Gumede, Louis A Van der Hoven, Gloria N De Gita, Elsabe J E De Kock, Telsa De Lange, Venessa Maseko, Valentia Kekana, Francois P Smuts, and Olga Perovic "Antimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa." <i>South African Medical Journal</i> 103, 6. (2013): 377 - 177. http://hdl.handle.net/11427/34890en_ZA
dc.identifier.citationLewis, D.A., Gumede, L.Y.E., Van der Hoven, L.A., De Gita, G.N., De Kock, E.J.E., De Lange, T., Maseko, V. & Kekana, V. et al. 2013. Antimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa. <i>South African Medical Journal.</i> 103(6):377 - 177. http://hdl.handle.net/11427/34890en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Lewis, David A AU - Gumede, Lindy Y E AU - Van der Hoven, Louis A AU - De Gita, Gloria N AU - De Kock, Elsabe J E AU - De Lange, Telsa AU - Maseko, Venessa AU - Kekana, Valentia AU - Smuts, Francois P AU - Perovic, Olga AB - BACKGROUND: Patients with community-acquired urinary tract infections (UTIs) frequently present to healthcare facilities in South Africa (SA). AIM: To provide information on UTI aetiology and antimicrobial susceptibility of pathogens. METHODS: We recruited women with UTI-related symptoms, who tested positive for ≥2 urine dipstick criteria (proteinuria, blood, leucocytes or nitrites) at 1 public and 5 private primary healthcare facilities in 2011. Demographic and clinical data were recorded and mid-stream urine (MSU) specimens were cultured. UTI pathogens were Gram-stained and identified to species level. Etest-based antimicrobial susceptibility testing was performed for amoxicillin/clavulanic acid, cefixime, cefuroxime, ciprofloxacin, fosfomycin, levofloxacin, nitrofurantoin, norfloxacin and trimethoprim/sulphamethoxazole. RESULTS: Of the 460 women recruited, 425 MSU samples were processed and 204 UTI pathogens were identified in 201 samples. Most pathogens were Gram-negative bacilli (GNB) (182; 89.2%) and 22 (10.8%) were Gram-positive cocci (GPC). Escherichia coli was the most frequent GNB (160; 79.6%), while Enterococcus faecalis was the predominant GPC (8; 4.0%). The UTI pathogens had similar susceptibility profiles for fosfomycin (95.5%; 95% confidence interval (CI) 92.6 - 98.4), the 3 fluoroquinolones (94.1%; 95% CI 90.8 - 97.4), nitrofurantoin (91.7%; 95% CI 87.8 - 95.6), cefuroxime (90.1%; 95% CI 86.0 - 94.3) and cefixime (88.2%; 95% CI 83.7 - 92.6). UTI pathogens were less susceptible to amoxicillin/clavulanic acid (82.8%; 95% CI 77.5 - 88.0) when compared with fluoroquinolones and fosfomycin. Trimethoprim/ sulphamethoxazole was the least efficacious antimicrobial agent (44.3% susceptible; 95% CI 37.4 - 51.2). CONCLUSION: This study provides relevant data for the empirical treatment of community-acquired UTIs in SA. DA - 2013 DB - OpenUCT DP - University of Cape Town IS - 6 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2013 SM - 0038-2469 T1 - Antimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa TI - Antimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa UR - http://hdl.handle.net/11427/34890 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34890
dc.identifier.vancouvercitationLewis DA, Gumede LYE, Van der Hoven LA, De Gita GN, De Kock EJE, De Lange T, et al. Antimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa. South African Medical Journal. 2013;103(6):377 - 177. http://hdl.handle.net/11427/34890.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Medical Microbiology
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue6
dc.source.journalvolume103
dc.source.pagination377 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.6722
dc.subject.otherUrinary Tract Infections
dc.subject.otherProteinuria
dc.subject.otherUrine
dc.subject.otherBlood
dc.subject.otherAnti-Infective Agents
dc.subject.otherSulfamethoxazole
dc.subject.otherTrimethoprim
dc.subject.otherNitrofurantoin
dc.subject.otherFluoroquinolones
dc.subject.otherCefuroxime
dc.subject.otherLevofloxacin
dc.subject.otherAmoxicillin-Potassium Clavulanate Combination
dc.subject.otherCefixime
dc.subject.otherNitrites
dc.subject.otherCiprofloxacin
dc.subject.otherFosfomycin
dc.subject.otherNorfloxacin
dc.subject.otherRivers
dc.subject.otherTherapeutics
dc.subject.otherDisk Diffusion Antimicrobial Tests
dc.subject.otherConfidence Intervals
dc.subject.otherEnterococcus faecalis
dc.subject.otherEscherichia coli
dc.subject.otherHomo sapiens
dc.subject.otherUrinary tract infection
dc.titleAntimicrobial susceptibility of organisms causing community-acquired urinary tract infections in Gauteng Province, South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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