Etiology and susceptibility of urinary tract isolates in Kosova.

Urinary tract infections are amongst the most common pathogenic infections with an increasing resistance to antimicrobials. The objective of this study was to determine the etiology and antimicrobial susceptibility patterns of urinary tract infection pathogens isolated in Kosovo. A retrospective study was carried from urine samples of both inpatients and outpatients that were received in our laboratory throughout 2001. During the study period, 16500 urine samples were analysed, of which 4260 (25.8%) had significant bacteriuria obtained from 1420 patients. Of this, 1059 (74.6%) were collected from females and 361 (25.4%) from males. Urine samples processed from outpatients were 72.5% (1029), whereas 27.5% (391) were from hospitalised patients. Escherichia coli was the most common aetiologic agent isolated (80.5%), followed by Proteus spp. (6.1%), Klebsiella spp. (5.9%), Citrobacter (5.1%) and Mycobacterium tuberculosis (0.8%). Gram-positive bacteria accounted for only 0.3%. Pseudomonas aeruginosa was only isolated from inpatients and was responsible for 0.6% of infections. Amoxicillin, ampicillin and trimethoprim-sulphamethoxazole resistance rates were 48.7, 46.5 and 32.1%, respectively. Nitrofurantoin, cefalexin and ciprofloxacin expressed the highest susceptibility among these isolates. E. coli isolates from inpatients and outpatients showed more than 25% resistance to trimethoprim-sulphamethoxazole. Of all isolates, 16% (225) were resistant to three or more agents and considered multi-drug resistant. Current data on the prevalence of multidrug resistance among urinary tract isolates should be a consideration to change the current empiric treatment of urinary tract infections.