Medical Laboratory Journal (Mar 2024)
New insight into antibiotic resistance in urinary tract infections: Interplay between community and hospital acquired UTI
Abstract
Background: Urinary tract infections (UTIs) are among the most common types of infections affecting people in community and hospital settings. Bacteria are the leading cause of UTIs, followed by fungi. 39% of all healthcare-associated infections (HAIs) affecting all age groups are UTIs, causing high morbidity and mortality rates. The antibiotic susceptibility pattern of causative organisms is changing due to improper antibiotic use. The study was conducted to determine the microbiological profile of both community and HAIs and their antimicrobial susceptibility pattern. Methods: Clean-catch, mid-stream urine samples collected in the universal wide-mouthed sterile containers were transported to the laboratory. Samples were processed by standard conventional microbiological procedures. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar plates. Results: The most common causative organisms among gram-negative bacteria were E coli (26.05%), followed by Klebsiella spp (20.37%), and Enterococcus spp (12.81%) was more common among the gram-positive bacteria. Non-albicans Candida (64.10%) were more commonly isolated than Candida albicans (35.90%). E coli was highly susceptible to nitrofurantoin and fosfomycin, and Klebsiella spp and Enterococcus spp were similarly highly susceptible. Antibiotic resistance was more common among bacteria isolated in HAIs. Conclusion: In both settings, E coli was the most common causative organism. The incidence of non-albicans Candida species has increased in comparison to Candida albicans. Antimicrobial susceptibility to empirical 3rd-generation cephalosporins and fluoroquinolones has drastically decreased. Hospital-acquired UTIs are a rising threat to the healthcare system and community. Based on hospitals’ antimicrobial policy formulated by studying antimicrobial susceptibility patterns, empirical treatment should be chosen.
