Bacterial susceptibility patterns to cotrimoxazole in urinary tract infections of outpatients and inpatients in Jakarta, Indonesia

  • Yeva Rosana Department of Microbiology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-5502-5593
  • Dwiana Ocviyanti Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Wafridha Akbar Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Keywords: cotrimoxazole, inpatients, outpatients, urinary tract infections
Abstract viewed: 130 times
PDF downloaded: 138 times
HTML downloaded: 17 times
EPUB downloaded: 27 times

Abstract

BACKGROUND Cotrimoxazole, which has been one of the drugs of choice for urinary tract infections (UTIs) since 1960, must be evaluated to determine whether it is still a relevant drug for this use. This study aimed to assess the susceptibility patterns to cotrimoxazole of the bacteria that cause UTIs from urine samples of female outpatients (community-acquired [CA]-UTI) and inpatients (hospital-acquired [HA]-UTI) in Jakarta.

METHODS This study was conducted from December 2014 to December 2015. Susceptibility testing of bacteria causing UTIs was conducted on 27 of 311 female outpatient urine samples collected from six clinics in Jakarta, and secondary data susceptibility testing was performed on 27 of 107 urine samples of inpatients from hospitals in Jakarta. These samples were examined in the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital.

RESULTS Susceptibility to cotrimoxazole was reported in 83% of the bacteria causing UTIs in CA-UTI and 44% of the bacteria in HA-UTI patients. Klebsiella pneumoniae was the most common cause of CA-UTI, with all isolates susceptible to cotrimoxazole (100%). Conversely, Escherichia coli was the most common cause of HA-UTI but was only susceptible in some isolates (44%). Bacteria from CA-UTI patients were almost twice as susceptible to cotrimoxazole compared with HA-UTI patients (p = 0.003).

CONCLUSIONS Based on the susceptibility patterns identified, cotrimoxazole can be used as a treatment for CA-UTI but not for HA-UTI patients in Jakarta, Indonesia.

References

  1. Salvatore S, Salvatore S, Cattoni E, Siesto G, Serati M, Sorice P, et al. Urinary tract infections in women. Eur J Obstet Gynecol Reprod Biol. 2011;156(2):131-6. https://doi.org/10.1016/j.ejogrb.2011.01.028

  2. Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. Med Clin North Am. 2011;95(1):27-41. https://doi.org/10.1016/j.mcna.2010.08.023

  3. Al Benwan K, Al Sweih N, Rotimi VO. Etiology and antibiotic susceptibility patterns of community- and hospital-acquired urinary tract infections in a general hospital in Kuwait. Med Princ Pract. 2010;19(6):440-6. https://doi.org/10.1159/000320301

  4. Wilson ML, Gaido L. Laboratory diagnosis of urinary tract infections in adult patients. Clin Infect Dis. 2004;38(8):1150-8. https://doi.org/10.1086/383029

  5. Katzung BG, Masters SB, Trevor AJ. Sulfonamide, trimethoprim, & fluoroquinolones. In: Basic and clinical pharmacology. 11th ed. USA: McGraw-Hill Companies, Inc; 2009. p. 817-9.

  6. Indonesian Ministry of Health. Decree of the Minister of Health of the Republic of Indonesia No. 312/MENKES/SK/IX/2013 about national list of essential medicines 2013. Jakarta [Indonesia]; 2013. Indonesian.

  7. Ocviyanti D, Fernando D. Management and prevention of urinary tract infections in pregnancy. J Indon Med Assoc. 2012;62(12):482-6. Indonesian.

  8. Duerink DO, Lestari ES, Hadi U, Nagelkerke NJ, Severin JA, Verbrugh HA, et al. Determinants of carriage of resistant Escherichia coli in the Indonesian population inside and outside hospitals. J Antimicrob Chemother. 2007;60(2):377-84. https://doi.org/10.1093/jac/dkm197

  9. Karuniawati A, Yulia RS, Budiyanti A, Prasetyo DS. Sensitivity to Gram negative bacteria originating from non-ICU patients. In: Results of tests of bacterial sensitivity to various antibiotics years; 2012. Jakarta: Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia; 2012. p. 12. Indonesian.

  10. Teichmann A, Agra HN, Nunes Lde S, da Rocha MP, Renner JD, Possuelo LG, et al. Antibiotic resistance and detection of the sul2 gene in urinary isolates of Escherichia coli in patients from Brazil. J Infect Dev Ctries. 2014;8(1):39-43. https://doi.org/10.3855/jidc.3380

  11. Parsons KF, Poitiers JI, Fall M, Irani J, LIorente C, Loch T, et al. Urological infection. In: Association of Urology guidelines. Europe. EAU. 2014:832.

  12. Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I, Purwanto SH. Estimated sample size. In: Fundamentals of clinical research methodology. 4th ed. Jakarta: Sagung Seto; 2011. p. 348-81. Indonesian.

  13. Bolton M, Horvath DJ Jr, Li B, Cortado H, Newsom D, White P, et al. Intrauterine growth restriction is a direct consequence of localized maternal uropathogenic Escherichia coli cystitis. PLoS One. 2012;7(3):e33897. https://doi.org/10.1371/journal.pone.0033897

  14. Santoso BI, Surya R, Yasmin FA, Irwinda R. The awareness of urinary tract infection management in pregnant women. A qualitative study. Majalah Obstet Ginekol. 2017;25(3):92-6. https://doi.org/10.20473/mog.V25I32017.92-96

  15. Duerink DO, Roeshadi D, Wahjono H, Lestari ES, Hadi U, Wille JC, et al. Surveilance of healthcare-associated infections in Indonesian hospitals. J Hosp Infect. 2006;62(2):219-29. https://doi.org/10.1016/j.jhin.2005.08.004

  16. Huang LF, Lo YC, Su LH, Chang CL. Antimicrobial susceptibility patterns among Escherichia coli urinary isolates from community-onset health care-associated urinary tract infection. J Formos Med Assoc. 2014;113(12):970-3. https://doi.org/10.1016/j.jfma.2014.01.009

  17. Vachhani AV, Barvaliya M, Naik V, Jha P, Tripathi C. Effectiveness and tolerability of short course co-trimoxazole, norfloxacin and levofloxacin in bacteriological cure of uncomplicated urinary tract infection in outpatient setting. An open label, parallel group, randomized controlled trial. Infez Med. 2015;23(2):155-60.

  18. Hussein NS. Clinical, etiology and antibiotic susceptibility profiles of community-acquired urinary tract infection in a Baghdad Hospital. Med Surg Urol. 2014;3(2):1000136.

  19. Goldberg E, Bishara J. Contemporary unconventional clinical use of co-trimoxazole. Clin Microbiol Infect. 2012;18(1):8-17. https://doi.org/10.1111/j.1469-0691.2011.03613.x

  20. Sari PA, Erly, Arisanty D. Comparison of the Inhibitory effectiveness of generic and patented cotrimoxazole on the growth of Escherichia coli bacteria as a cause of urinary tract infection in vitro. J Kesehatan Andalas. 2015;3(1): 227-32. Indonesian.

  21. Toval F, Köhler CD, Vogel U, Wagenlehner F, Mellmann A, Fruth A, et al. Characterization of Escherichia coli isolates from hospital inpatients or outpatients with urinary tract infection. J Clin Microbiol. 2014;52(2):407-18. https://doi.org/10.1128/JCM.02069-13

  22. Irenge LM, Kabego L, Vandenberg O, Chirimwami RB, Gala JL. Antimicrobial resistance in urinary isolates from inpatients and outpatients at a tertiary care hospital in South-Kivu Province (Democratic Republic of Congo). BMC Res Notes. 2014;7:374. https://doi.org/10.1186/1756-0500-7-374

  23. Hsueh PR, Hoban DJ, Carmeli Y, Chen SY, Desika S, Alejandria M, et al. Consensus review of the epidemiology and appropriate antimicrobial therapy of complicated urinary tract infections in Asia-Pasific region. J Infect. 2011;63(2):114-23. https://doi.org/10.1016/j.jinf.2011.05.015

  24. Tantry BA, Rahiman S. Antibacterial resistance and trend of urinary tract pathogens to commonly used antibiotics in Kashmir Valley. West Indian Med J. 2012;61(7):703-7.

  25. Gupta A, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 updated by the Infectious Disease Society of America and European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-20. https://doi.org/10.1093/cid/ciq257

  26. Leblebicioglu H, Ozaras R, Sunbul M. Role of co-trimoxazole for urinary tract infections in developing countries. Lancet Infect Dis. 2015;15(7):764-5. https://doi.org/10.1016/S1473-3099(15)00076-6

Published
2020-10-05
How to Cite
1.
Rosana Y, Ocviyanti D, Akbar W. Bacterial susceptibility patterns to cotrimoxazole in urinary tract infections of outpatients and inpatients in Jakarta, Indonesia. Med J Indones [Internet]. 2020Oct.5 [cited 2020Dec.3];29(3):316-21. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/4305
Section
Clinical Research