Abstract
Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide and are becoming increasingly complicated by the emergence of multidrug-resistant pathogens. Enterococcus faecalis and Pseudomonas aeruginosa are important pathogens of UTIs, particularly in hospitalized patients. Their rising resistance to multiple antibiotic classes poses a serious challenge to treatment and infection control, especially in low-income and middle-income countries, including Vietnam. Accordingly, this study aimed to determine the frequency of E. faecalis and P. aeruginosa in UTIs and assess their antibiotic-resistance status at Da Nang C Hospital, Central Vietnam, in 2022.
Methods: This retrospective cross-sectional study was conducted on 299 bacterial strains isolated from the urine specimens of patients diagnosed with UTIs at Da Nang C Hospital in 2022. These strains were identified through culture analysis, and their antibiotic susceptibility was assessed using the disk-diffusion method (Kirby-Bauer test).
Results: E. faecalis and P. aeruginosa were found in 10.03% and 8.7% of cultures, respectively. All isolates of E. faecalis were completely susceptible to linezolid, and most of them were susceptible to rifampin (93.8%) and vancomycin (86.2%). In addition, many of these isolates were susceptible to penicillin G, ampicillin, doxycycline, and chloramphenicol (67.9–77.8%). Resistance to ciprofloxacin, tetracycline, levofloxacin, and erythromycin was detected in 68–88.9% of isolates. Regarding P. aeruginosa, 53.8% to 66.7% of cultures were resistant to levofloxacin, gentamicin, ciprofloxacin, tobramycin, ofloxacin, and nitrofurantoin. However, P. aeruginosa was highly susceptible to piperacillin/tazobactam (87.5% of isolates), imipenem (75%), cefoperazone/sulbactam (72.7%), and cefepime and meropenem (64%). Eventually, multidrug resistance was observed in 56.7% and 34.6% of E. faecalis and P. aeruginosa isolates, respectively.
Conclusion: The bacteria isolated in this study exhibited resistance to many commonly used antibiotics at various levels. Our findings demonstrated the critical need for more stringent antibiotic stewardship guidelines and routine surveillance in order to enhance patient outcomes and prevent the spread of resistant bacteria.