Study Of Community and Nosocomial Uropathogens and Their Drug Resistance

Abstract

Background: Urinary tract infections (UTI) are amongst the most common infectionsencountered in clinical practice. Drug resistant uropathogenshas been increasingly observed, not only in nosocomial UTI but also in community-acquired (CA) UTI leaving very few options for the treatment. CA and nosocomial UTI differ aetiologically, epidemiologically; they also have different antibiotic resistance pattern. Therefore, we planned to study the bacterial aetiology and antibiotic susceptibility of uropathogens in CA and nosocomial UTI and compared them. Methods: Uropathogens were isolated and identified as per standard microbiological techniques from urine samples of patients with CA and nosocomial UTI. The antibiotic susceptibility testing was performed as per clinical and laboratory standards institute (CLSI) 2012 guidelines. Results: Amongst 1948 urine samples collected from UTI patients, 1697 (87.1%) were from the CA infections and 251 (12.9%) were from the nosocomial infections.E. coli was the most common organism isolated from both CA(60.1%) and nosocomial (33%)UTI. Non-fermenters, enterococci, candida were more common in nosocomial UTI. Resistance to routinely prescribed urinary antibiotics such as norfloxacin and cotrimaxazole was observed in CA strains of E. coli and klebsiella.In nosocomial uropathogens, in addition to cephalosporins and aminoglycosides, resistance to piperacillin-tazobactam and carbapenems was observed.Overall, drug resistance was more in nosocomial as compared to CA uropathogens. Conclusion: The periodic update of local aetiology and antibiotic susceptibility of community and nosocomial uropathogens is necessary.

Keywords

• Uropathogen
• drug resistance
• community-acquired UTI
• nosocomial UTI