Antimicrobial Resistance of the Most Prevalent Urinary Isolates from Outpatients of the Upper Vrbas Region in Bosnia and Herzegovina

The aim of the study was to determine the frequency and antibiotic susceptibilityof urinary pathogens isolated from outpatients of both genders divided into three age categories. A prospective study was carried out in the period from December 2017 to April 2018 of the Upper Vrbas Region in Bosnia and Herzegovina. Midstream samples of urine (1 444) were taken and sent to the microbiologic laboratory for further evalu¬ation. Antibioticssusceptibility patternsaccording to EUCAST standards were observed. Data were analyz¬ed by age and gender. The results showed that E. coli was the most prevalent cause of urinary infections in females (86%), followed by Klebsiella pneumoniae (16%). The most prevalent isolates in males were caused by Enterobacter spp. (37%), K. pneumoniae (33%), and besides that, strains of Enterococcus genus were reported. E. coli showed the highest resistance to ampicillin (77% in females vs. 100% in males) and gentamycin (100% in females vs. 45% in males) but also high resistance to cephalosporines (30-50%), fluoroquinolones (30%) and penicillin. Enterococcus spp. isolates showed resistance to trimethoprim/sul¬famethoxazole and phosphomycin in males (100%), but were also highly resistant to fluoroquinolone activ¬ity. Isolates of Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, Hafnia alvei, Serratia marcescens and Acinetobacter spp. showed low resistance percentages. In conclusion, E. coli is the most prevalent cause of urinary tract infections, especially in females. In addition to E. coli, a large number of female urinary infections are caused by K. pneumoniae, Enterococcus spp. and Enterobacter spp.