Isolation rates and antibiotic susceptibilities of different Enterobacteriaceae species as urinary tract infection agents in Turkey: a systematic review

Abstract

Background/aim: In Turkey, few systematic reviews have analyzed the results of studies on the isolation rates of urinary tract infection agents and their antibiotic susceptibilities. This review was done to fill this gap and enable the correct application of guideline-based medical therapy by determining the isolation rates and antibiotic susceptibilities of different Enterobacteriaceae species in Turkey. Materials and methods: Relevant studies found from various databases with the help of previously specified search strategies were examined and eliminated according to eligibility criteria. The remaining 22 studies were included in this systematic review. Results: Escherichia coli was the most frequently isolated species among all agents in both in- and outpatient settings. Only the antibiotic susceptibility data of E. coli could be analyzed because among the 22 studies only E. coli had adequate antibiotic susceptibility data to be analyzed. The calculated resistance rates of the most frequently preferred antibiotics (trimethoprim/sulfamethoxazole, ciprofloxacin, and ceftriaxone) were 46%, 32%, and 19% for outpatients and 54%, 48%, and 28% for inpatients, respectively. Conclusion: The resistance profiles of commonly used antimicrobial agents are much higher than the thresholds set by international guidelines. Hence, treatment algorithms for urinary tract infections should be designed according to Turkey's antimicrobial resistance patterns.