UROPATHOGENS AND THEIR RESISTANCE PATTERN IN URINARY TRACT INFECTION CASES OF TERTIARY CARE HOSPITAL, BHOPAL

surender kaur; Abhijit Awari

doi:10.22159/ajpcr.2023.v16i5.46761

Authors

surender kaur Department of Microbiology, BRLSABVM Government Medical College, Rajnandgaon, Chhattisgarh, India.
Abhijit Awari Department of Microbiology, BRLSABVM Government Medical College, Rajnandgaon, Chhattisgarh, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i5.46761

Keywords:

Escherichia coli, Klebsiella pneumoniae, Urinary tract infection, Antibiotic resistance, Uropathogens

Abstract

Objectives: Urinary tract infections (UTIs) are an increasing public health problem caused by various uropathogens. To assess the adequacy of empirical therapy, an antibiogram of the bacteria responsible for UTI in patients coming to the tertiary hospital, Bhopal was evaluated for 13 months.

Methods: In this prospective and observational study, all urine samples from patients of a tertiary care hospital collected at the Department of Microbiology, Peoples College of Medical Sciences and Research Centre, Bhopal, from January 2014 to January 2015 were processed. A sample with more than 105 CFU/mL of bacteria was considered positive, the bacteria were identified, and antibiotic susceptibility profile was characterized.

Results: A total of 283 urine samples from suspected UTIs were analyzed, for which identification of bacteria and antimicrobial susceptibility testing were done. Overall, 56.53% were culture positive with a predominance of female patients (70.62%). Females 26–35 years old and males ≥46 years old showed maximum culture positivity. Escherichia coli (55.7%) was the most commonly isolated microorganism, followed by Klebsiella pneumoniae (24.8%). Isolated uropathogens were predominantly resistant to Ampicillin, Amoxycillin clavulanic acid, Cefotaxime, Ceftazidime, Cotrimoxazole, and Nalidixic acid.

Conclusion: Our study confirms a global trend toward increased resistance to most antibiotics. We emphasize the formulation of antibiotic policy for a particular geographical area. E. coli was the most common uropathogen. Nitrofurantoin, Fluoroquinolones, Amikacin, and Piperacillin/tazobactam were the most effective antibiotics against uropathogens.

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Author Biography

Abhijit Awari, Department of Microbiology, BRLSABVM Government Medical College, Rajnandgaon, Chhattisgarh, India.

Professor and HOD department of microbiology DVVPFS Medical college Ahmednagar Maharashtra 414111

References

Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in J N M C Hospital Aligarh, India. Ann Clin Microbiol Antimicrob 2007;6:4. doi: 10.1186/1476-0711-6-4, PMID 17378940

Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA). Clin Infect Dis 1999;29:745-58. doi: 10.1086/520427, PMID 10589881

Stamm WE. Urinary tract infections and pyelonephritis. In: Kasper DL, Braunwald E, Fauci AS, editors. Harrison’s Principles of Internal Medicine. 16th ed. New York: McGraw-Hill Companies Inc.; 2005. p. 1715-21.

Momoh A, Orhue P, Idonije O, Oaikhena A, Nwoke E, Momoh A. The antibiogram types of Escherichia coli isolated from suspected urinary tract infection samples. J Microbiol Biotechnol Res 2011;1:57-65.

Sood S, Gupta R. Antibiotic resistance pattern of community-acquired uropathogens at a tertiary care hospital in Jaipur, Rajasthan. Indian J Community Med 2012;37:39-44. doi: 10.4103/0970-0218.94023, PMID 22529539

Collee JG, Miles RS, Watt B. Test for identification of bacteria. In: Fraser AG, Marmion BP, Simmons A, editors. Mackie and McCartney Practical Medical Microbiology. 14th ed. London: Churchill Livingstone Inc; 1996. p. 435.

Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. 24th ed. CLSI Supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2014.

Waske S, Marothi Y, Shah H, Pradhan R. Antibiotic resistance pattern of uropathogens in a tertiary care hospital of Central India. Int J Med Microbiol Trop Dis 2017;3:61-4.

Prakash D, Saxena RS. Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of Meerut City, India. ISRN Microbiol 2013;2013:749629. doi: 10.1155/2013/749629, PMID 24288649

Foxman B, Zhang L, Tallman P, Andree BC, Geiger AM, Koopman JS, et al. Transmission of uropathogens between sex partners. J Infect Dis 1997;175:989-92. doi: 10.1086/514007, PMID 9086166

Mallla KK, Sharma MS, Malla T, Thapalial A. Clinical profile, bacterial isolates and antibiotic susceptibility pattern in urinary tract infection in children-hospital base study. J Nepal Paediatr Soc 2008;28:52-61.

Devki V, Sneha M, Yogesh C. Antibiogram profile of uropathogens in a tertiary Care Hospital in western Uttar Pradesh, India. Int J Curr Microbiol Appl Sci 2016;5:422-30. doi: 10.20546/ijcmas.2016.506.049

Ochei J, Kolhatkar A. Diagnosis of infection by specific anatomic sites/antimicrobial susceptibility tests. In: Medical Laboratory Science Theory and Practicereprint. 6th ed. New Delhi, India: McGraw-Hill; 2007. p. 615-43, 788-98.

Kolawole AS, Kolawole OM, Kandaki-Olukemi YT, Babatunde SK, Durowade KA, Kolawole CF. Prevalence of urinary tract infections (UTI) among patients attending Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. Int J Med Med Sci 2009;1:163-7.

Smita MS, Wavare SS, Gajul S, Sajjan AG. Bacterial profile of urinary tract infections and antibiotic resistance pattern in a tertiary Care Hospital. Online J Health Allied Sci 2019;18:6.

Das RN, Chandrashekhar TS, Joshi HS, Gurung M, Shrestha N, Shivananda PG. Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal. Singapore Med J 2006;47:281-5. PMID 16572238

Majumder MM, Ahmed T, Ahmed S, Khan AR, Saha CK. Antibiotic resistance in urinary tract infection in a Tertiary Care Hospital in Bangladesh-a follow-up study. Med Today 2019;31:9-14. doi: 10.3329/ medtoday.v31i1.40314

Laghawe A, Tripathi A, Saxena SB. Aetiology of urinary tract infection and antimicrobial susceptibility pattern of urinary isolates in tertiary care hospital in central India: A retrospective analysis. Int J Curr Microbiol Appl Sci 2015;4:962-70.

Gupta K, Sahm DF, Mayfield D, Stamm WE. Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in women: A nationwide analysis. Clin Infect Dis 2001;33:89- 94. doi: 10.1086/320880, PMID 11389500

Rakesh K, Dahiya SS, Kirti H, Preeti S. Isolation of human pathogenic bacteria causing urinary tract infection and their antimicrobial susceptibility pattern in a tertiary care hospital, Jaipur, India. Int Res J Med Sci 2014;2:6-10.

Deshpande KD, Pichare AP, Suryawanshi NM, Davane MS. Antibiogram of gram negative uropathogens in hospitalized patients. Int J Recent Trends Sci Technol 2011;1:56-60.

Baveja CP, Perween N, Aggarwal P. Urinary tract infections in tertiary care hospital in North India: Etiology and antimicrobial susceptibility pattern. J Med Sci Clin Res 2014;2:2940-6.

McEwen LN, Farjo R, Foxman B. Antibiotic prescribing for cystitis: How well does it match published guidelines? Ann Epidemiol 2003;13:479-83. doi: 10.1016/s1047-2797(03)00009-7, PMID 12875808