Title: Microbiological Profile of Urinary Tract infections among Patients attending a Tertiary care Hospital
Authors: Dr Dekyong Angmo, Dr Shaista Nazir, Dr Bashir A Fomda, Dr Shadan Akhtar, Dr Shazia Benazir, Dr Asifa Bhat, Dr Leenah Bashir
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.51
Abstract
Background: UTI is a common infection among all age groups. Timely detection and management of urinary tract infection is important as it leads to varied morbidity and mortality. Causative agents of UTI are E.coli, Klebsiella spp, Proteus spp, Pseudomonas spp, Staphylococcus spp, Enterococcus spp. In recent years resistance has been seen to various antibiotics used to treat urinary tract infection. Therefore, it is important to know the antibiotic profile of various organism involved in causing urinary tract infection. Thus, this study aimed to determine the bacteriologic agents causing UTI and to evaluate their in vitro susceptibility pattern
Material and Methods: Urine sample from 2100 patients with clinical symptoms of UTI were collected. Pure isolated bacteria were identified using biochemical tests and subjected to antimicrobial susceptibility testing using disc diffusion method as per CLSI guidelines.
Results: Escherichia coli 114(57.3%) was the predominant organism followed by Klebsiella pneumoniae 22(11.1%) and enterococcus fecalis 19(9.5 %). E. coli resistance to various antibiotics were as follows, cotrimoxazole (67.5%) , norfloxacin (66.6%), cefoperazone/sulbactam (57%), piperacillin/tazobactam (50.8%), nitrofurantoin (35%), ertapenem(33.3%), gentamicin and meropenem (32.4%), ciprofloxacin (23.6%) imipenem (14%) and amikacin (13.1%) . K. pneumoniae showed resistance to cotrimoxazole (77.2%) , nitrofurantoin (72.7%), cefoperazone/sulbactam (68.1%), gentamicin (54.5%), piperacillin/tazobactam and ciprofloxacin (50%) , norfloxacin (45.4 %), imipenem (40.9%) ,ertapenem(31.8%), meropenem and amikacin (9.09%). E.fecalis showed 57.8% resistance to levofloxacin, ampicillin, ampicillin/sulbactam, amoxicillin/clavulanic acid and piperacillin/tazobactam (26.3%), nitrofurantoin(10.5%). All isolates of E.fecalis were sensitive to vancomycin and linezolid.
Conclusion: Findings from this study revealed that E.coli remains the most predominant etiology of UTIs followed by Klebsiella. Resistance of E.coli was high towards cotrimoxazole, flouroquinolones and cephalosporins. Klebsiella showed high resistance to cotrimoxazole, nitrofurantoin, gentamicin, cephalosporins, flouroquinolones. E.fecalis showed 57.8% resistance to levofloxacin, penicillins. The results show that the antimicrobial resistance patterns of the causes of UTI are highly variable and continuous surveillance of trends in resistance patterns of uropathogens is important. The presence of multi-drug resistance bacteria was high. Hence, It’s necessary to treat UTIS patients based on microbiology test results in order to prevent or minimize emergence and spread of multidrug resistant bugs.
Keywords: Urinary tract infection, Antibiogram, Culture, Invitro susceptibility.
