Infecciones De Tracto Urinario

Hindawi Publishing Corporation
Chemotherapy Research and Practice
Volume 2011, Article ID 218431, 6 pages
doi:10.1155/2011/218431

Research Article
Escherichia coli Isolated from Urinary Tract
Infections of Lebanese Patients between 2000 and 2009:
Epidemiology and Profiles of Resistance
Ziad Daoud1 and Claude Afif2
1 Faculty
2 Faculty

of Medicine and Medical Sciences, University ofBalamand, P.O. Box 100, Tripoli, Lebanon
of Medicine and Medical Sciences, University of Balamand, P.O. Box 166378, Beirut, Lebanon

Correspondence should be addressed to Ziad Daoud, ziad.daoud@balamand.edu.lb
Received 1 July 2011; Revised 10 August 2011; Accepted 13 August 2011
Academic Editor: Spyros Pournaras
Copyright © 2011 Z. Daoud and C. Afif. This is an open access article distributedunder the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
The purpose of this study was to investigate the bacterial etiology of urinary tract infections in one of the busiest hospitals of
Lebanon and to examine the epidemiologic and microbiologic properties of Escherichia coliisolated from urinary tract infections
of Lebanese patients over a 10-year period. Methods. This retrospective study analyzed the data generated between 2000 and
2009 (10,013 Gram-positive and Gram-negative bacteria). Bacterial identification was based on standard culture and biochemical
characteristics of isolates. Antimicrobial susceptibility was tested by the disk diffusion method, and ESBLproduction was detected
by synergy with third-generation cephalosporins and amoxiclav. Results. E. coli was the most frequent isolate throughout the ten
years (60.64% of the total isolates). It was followed by Klebsiella pneumoniae and Proteus sp., Pseudomonas aeruginosa, Enterococcus
sp., and Streptococcus agalactiae. E. coli occurred more frequently in women (69.8%) than in men (61.4%). The lowestpercentage
of susceptibility of E. coli was manifested against piperacillin and ampicillin. An increase in the production of ESBL was observed
(2.3% in 2000 to 16.8% in 2009). Conclusions. The etiology of urinary tract infections and their susceptibility profiles are important
to be evaluated in countries like Lebanon where a severe misuse of antibiotics at all levels is observed.

1.Introduction
Urinary tract infections (UTIs) are one of the most common
infectious diseases [1–3]. They may be symptomatic or
asymptomatic, and either type of infection can result in
serious sequelae if not appropriately treated [4]. Although
different causative agents can be responsible for UTIs, bacteria are the major cause being responsible for more than 95%
of UTI cases [5]. In this context, E.coli is the most prevalent
organism and is solely responsible for the majority of these
infections. An accurate and prompt diagnosis is important in
shortening the disease course and for preventing the ascent
of the infection to the upper urinary tract [6]. Treatment
of UTI is often started empirically. UTIs are often treated
with different broad-spectrum antibiotics when one with
a narrowspectrum of activity may be appropriate because
of concerns about infection with resistant organisms, and
antimicrobial susceptibility testing of the urinary pathogens

constitutes the basis for antibiotic therapy. However, in view
of the increasing bacterial resistance, regular monitoring of
resistance patterns is necessary to improve guidelines for
empirical antibiotic therapy [6–8]. Thepresent study aims at
analyzing the infectious epidemiology of UTIs in a general
university hospital located in Beirut over a period of ten
years. In addition, it examines the susceptibility profiles of
E. coli between 2000 and 2009.

2. Material and Methods
2.1. Study Design. This is a retrospective study conducted
at the Microbiology section of the Medical Laboratories
of the Saint...