Bacteriological profile and antimicrobial susceptibility pattern of patients with urinary tract infections in a tertiary care hospital in a tertiary care center

Abstract

ABSTRACT Background: Urinary Tract Infections (UTIs) are one of the most commonly occurring infections in medical practice despite the widespread availability of antibiotics. The emergence of antimicrobial resistance in uropathogens may lead to poor treatment outcomes in individuals with UTIs. The knowledge of the microorganism involves and antibiograms are important for the empirical treatment of UTIs. Aims and Objectives: This study was undertaken to evaluate the bacteriological profile of UTI patients and to know their antimicrobial susceptibility pattern. Material and Methods: A cross-sectional study was carried out over 6 months (from July 2021 to December 2021) with a focus on the identification of bacterial pathogens causing UTI and the evaluation of their antibiogram. Mid-stream urine samples were collected from a total of 2825 subjects with clinically suspected acute UTI. Urine samples were aseptically collected in sterile containers and inoculated aseptically on to Hi-Chrome UTI agar. Isolation and identification of the bacterial strains were performed using standard microbiological protocols. Antibiotic susceptibility was carried out following CLSI recommended guidelines. Only culture proven cases, were included in this study. Results: A total of 2825 urine samples were processed for urine culture and sensitivity out of which 804 samples were found to be positive for bacterial infection (amounting to 28.46% positivity). Gram -negative bacteria accounted for 58.5 % (471/804) and Gram -positive 33% (267/804) of the positive results. Among Gram -negative isolates, E. coli(33.8%) and K. pneumoniae (10.8%) were the most prevalent microorganisms while as Enterococcus sp (26.3%) was the most common Gram -positive organism isolated followed by Staphylococcus aureus. Gram negative bacteria on the whole showed a high degree of resistance to cephalosporins and quinolones while as nitrofurantoin was the most effective antibiotic against E. coli and K. pneumoniae. In case of Gram-positive bacteria linezolid and vancomycin were the most effective antibiotics. Conclusion: The results of this study revealed a great concern for emerging UTI‑related multidrug‑resistant strains of bacteria causing UTI. The need of the hour is continuous monitoring of susceptibility patterns of specific pathogens to commonly used antimicrobial agents before initiation of antibiotic therapy.

Keywords

• urinary tract infection
• antibiotic susceptibility
• uropathogens
• e.coli.