Antibiotic Resistance Crisis in Urinary Tract Infections Utis in Egypt

Abstract Introduction/Objective Bacterial adaptation to antibiotics has been very successful. Over the past decade, the increase in antibiotic resistance has generated considerable medical problems. UTIs are one of the most common community-onset infections. The emergence of resistance to all classes of antibiotics in previously susceptible bacterial pathogens is a major challenge to infectious disease medicine. Thus, it is important that we forcefully implement strategies to reduce the rate of appearance and spread of resistant bacteria to allow new drug discovery to catch up with bacterial resistance development. Objectives: Methods The aim of this study is to predict the percentage of urine cultures antibiotic resistance in patients with UTIs in Egypt. Subjects and methods: A total of 200 subjects were enrolled in this study from The Delta region in Egypt; 38% males and 62% females with a median age of 39 years and 35 years respectively. Identification of the isolated organisms was identified by the cultural characters (Morphological characters of the purified bacterial isolates were carried out according to the colony characters, Gram stain reaction and biochemical tests for each organism using a standard semi-automated technique Results 98 cultures (49%) were observed to have resistance to 3- 5 classes of antibiotics including, 98% Cephalosporins, 85% β-lactam inhibitors and 71% fluoroquinolones; 66 females (57 gram -ve stain and 9 gram +ve stain) and 33 males (27gm -ve stain, 6gm +ve stain). 82 cultures (41%) were not resistant to any classes.; 32 males (28 gram -ve stain and 3 gram +ve stain) and 50 females (45 gram -ve stain and 5 gram +ve stain). 19 cultures (9.5%) were observed to be resistant to all antibiotics.; 12 males (11 gram -ve stain and 1 gram +ve stain) and 7 females (2 gram -ve stain and 5 gram +ve stain). Conclusion This study highlights the highest antibiotic resistance associated with urinary tract infection in Egypt as well as the classification of the organisms. The high resistance percentage is due to the overuse of antibiotics by public and inappropriate antibiotic prescribing. Antibiotics are unregulated and available over the counter without a prescription in Egypt which makes it easily accessible. We recommend regulating the use of antibiotics and lunch antimicrobial stewardship programs in Egypt.