scholarly journals Assessment of urinary tract infection and their resistance to antibiotics in diabetic and non-diabetic patients

2016 ◽  
Vol 9 (3) ◽  
pp. 151 ◽  
Author(s):  
Nureen Zahra ◽  
Kanwal Rehman ◽  
Rana Aqeel ◽  
Asia Parveen ◽  
Muhammad Sajid Hamid Akash

Diabetic patients are more susceptible to urinary tract infections (UTIs) than non-diabetic patients and due to the development of multidrug resistant uropathogenic strains, the choice of antibacterial agents is being limited. The study was undertaken to determine the influence of diabetes mellitus on the uropathogens and antibiotic sensitivity pattern among patients with UTIs. A cross-sectional study was conducted in which total of 400 patients were studied out of which 150 were diabetics and 250 were non-diabetics. Patients with negative urine culture (n = 240) were excluded from the study and 160 patients with positive culture of UTIs of which 80 were diabetics and 80 were non-diabetics, included in this study. Clinical data were obtained from individual study participant with informed written consent using pre-tested questionnaire. According to the clean-catch procedure, midstream urine samples were collected and cultured for the diagnosis and susceptibility of bacteriuria. Out of 160 uropathogenic isolates, <em>E. coli</em> was found as a leading pathogen i.e. 46.25% followed by <em>Candida spp</em>. 30.62%, <em>S. Faecalis</em> 15.62%, <em>P. aeruginosa</em> 3.13%, <em>Pneumococcus</em>. 1.25%, MSSA 1.25%, MRSA 0.63%, <em>Proteus spp</em>. 0.63% and <em>Vancomycin resistant enterococcus spp.</em> 0.63%. The results indicated that prevalence of UTIs was significantly higher in diabetic patients than in non-diabetic subjects. <em>E. coli</em> was found to be the most common isolate. It was observed that UTIs in diabetic patients was more in female diabetic patients than in male patients. Investigation of bacteriuria in diabetic patients for UTIs is an important tool for the treatment and prevention of renal complications.

2015 ◽  
Vol 1 (4) ◽  
pp. 24-28 ◽  
Author(s):  
Dhruba Acharya ◽  
B Bogati ◽  
GT Shrestha ◽  
P Gyawali

The incidence of urinary tract infections (UTIs) is common in both diabetic and non diabetic patients. Since the microorganisms causing UTI vary in their susceptibility to antimicrobials from place to place and time to time, hence constant screening of trends and susceptibility pattern of predominant   organisms against antimicrobials is essential. The study aims to determine the spectrum of  ropathogens and antibiotic sensitivity pattern in both diabetic and non diabetic patients with clinically suspected UTI .A prospective cross sectional study was conducted during period of February 2013 to July 2013 among 90 diabetic and 90 non diabetic patients attending Dhulikhel Hospital-Kathmandu University Hospital,  Dhulikhel, Kavre (DH-KUH). All samples and isolates were investigated by standard laboratory rocedures. A total of 55 (30.5%) samples showed significant growth. No significant difference among culture positivity rate was noted between diabetic and non diabetic patients (34.5% Vs 26.7%). Escherichia coli was the most frequent organism (64.5% in diabetic and 66.7% non diabetic) followed by Klebsiella sps (22.6% in diabetic and 12.5% in non diabetic). Gentamycin and nitrofurantoin were highly sensitive to E. coli isolated in diabetic patients among the tested antimicrobials followed by  otrimoxazole, norfloxacin and ciprofloxacin. Least sensitivity rate was observed with ampicillin and cephalexin. However, no difference was noted on the sensitivity pattern of the antimicrobials among E. coli isolated between diabetic and non diabetic patients. In this study high proportion of gram negative bacilli with predominant uropathogen being E. coli was noted. Irrespective of the status of diabetes, Staphylococcus sps and Pseudomonas sps were not isolated from UTI patients in our study. The isolation of organisms and their resistance pattern was almost similar between diabetic and non diabetic patients.DOI: http://dx.doi.org/10.3126/jmmihs.v1i4.11998Journal of Manmohan Memorial Institute of Health SciencesVol. 1, Issue 4, 2015Page : 24-28


Author(s):  
Nikhil S. Yadav ◽  
Swanand S. Pathak

Background: Urinary tract infections are commonly seen in febrile children, high incidence of Vesico Ureteral Reflux (VUR) is frequently seen in paediatric patient which is of concern as it may lead to renal scarring. Despite presence of established clinical guidelines there is disparity amongst physician in the diagnosis and treatment of UTI, some physician prescribes taking into consideration the symptoms, some prescribe on the basis of smell and colour and some rely on urine culture and sensitivity report. There is dearth of studies in many tertiary health care centers regarding antimicrobial use. Authors conducted this study to evaluate antimicrobial sensitivity pattern, efficacy and cost effectiveness of antimicrobials used for UTI in children.Methods: Patients of urinary tract infection <13 years of age were included in the study. Symptoms of patient i.e. pain in abdomen, haematuria, increased frequency of urination and degree of fever were recorded. Efficacy was measured through calculating degree of defervescence per hour. Cost effective model was prepared by calculating cost effective ratio i.e. dividing cost of antimicrobial required to bring down the fever and degree through which fever came down.Results: E. coli was the most common pathogen isolated from urine positive culture (69.07%). Nitrofurantoin has shown highest sensitivity to all uropathogens (72.73%). Cotrimoxazole, ciprofloxacin and nitrofurantoin were found to be most cost effective.Conclusions: In this current study authors found E coli is the most common uropathogen isolated. Ceftriaxone, cefixime, cotrimoxazole and amikacin were found to be most efficacious. Cotrimoxazole, ciprofloxacin and nitrofurantoin were found to be most cost effective.


2021 ◽  
Vol 8 (10) ◽  
pp. 5692-5697
Author(s):  
Dr. Digbijay Kumar Thakur ◽  
Dr. Rameshwar Mahaseth ◽  
Dr. Shambhu Kumar Sah

Background: Urinary tract infections are most common bacterial infection in routine clinical practice. It is also most common nosocomial infection in many hospitals. Antibiotics are usually given empirically before urine culture reports available and treatment failure rate used to be significantly high. Study of causative agents and their antimicrobial sensitivity pattern are important factors helping formulating antibiotic policy. Generally, most common uropathogene is Escherichia Coli. Tertiary care hospitals, catering of already partially treated or mal treated patients as major chunk, may have varying etiologies and different sensitivity patterns. Objective: To study the culture and sensitivity patterns of urinary tract infections in patients presenting with urinary symptoms in local hospitals. Study design: A cross sectional study Materials and methods: Study was conducted at Madanta Research Clinic Private Limited from 12th march 021 to 12th September 021. Urine from cases suspected to have symptoms suggestive of UTI were send for bacteriological culture and sensitivity. Demographic profiles of each participant along with pathogen isolated, culture sensitivity pattern was documented. Data analysis was done in IBM spss 25. Results: A total 200 samples were selected for bacteriological culture and sensitivity out of which 32% were male and 68% were female. Around 50% of participants were in age group 20-40. There was no growth in 64% sample. Among positive samples (36%), E. coli (most common) was detected in 91.66%, Klebsiella was detected in 6.94%. Gentamicin, Amikacin and Nitrofurantoin were most common antibiotics sensitive to organisms in culture and Cephalosporins group of antibiotics are commonly resistant. Conclusions: coli is the most common organism isolated in urine culture in our region Janakpur. Cephalosporins are resistant in majority of cases where as Aminoglycosides like Amikacin, Gentamicin and Nitrofurantoin are found to be highly sensitive in most of positive cases.


2021 ◽  
Vol 6 (2) ◽  
pp. 49
Author(s):  
Gambhir Shrestha ◽  
Xiaolin Wei ◽  
Katrina Hann ◽  
Kyaw Thu Soe ◽  
Srinath Satyanarayana ◽  
...  

Cancer patients are at high risk of antibiotic resistant bacterial urinary tract infections (UTIs). In this study, we assessed the bacterial profile and antibiotic resistance among cancer patients suspected of UTI in B.P. Koirala Memorial Cancer Hospital in Nepal through a cross-sectional study with routinely collected data. All cancer patients who had a recorded urine culture between July 2018–June 2019 were included in the study. Out of 308 patients who had undergone culture, 73 (24%) of samples had bacterial growth. The most common organisms isolated were E. coli (58%), Staphylococcus (11%) and Klebsiella (10%). These bacteria had undergone susceptibility testing to 27 different antibiotics in various proportions. Of the limited antibiotic testing levels, nitrofurantoin (54/66, 82%) and amikacin (30/51, 59%) were the most common. Among those tested, there were high levels of resistance to antibiotics in the “Access” and “Watch” groups of antibiotics (2019 WHO classification). In the “Reserve” group, both antibiotics showed resistance (polymyxin 15%, tigecycline 8%). Multidrug resistance was seen among 89% of the positive culture samples. This calls for urgent measures to optimize the use of antibiotics in UTI care at policy and health facility levels through stewardship to prevent further augmentation of antibiotic resistance among cancer patients.


2019 ◽  
Vol 5 (1) ◽  
pp. 58-62
Author(s):  
Ram Wagle ◽  
Rajendra Timilsina ◽  
Rojesh Thapa ◽  
Nabaraj Adhikari ◽  
Upendra Thapa Shrestha ◽  
...  

Urinary tract infection (UTI) is defined as colonization of pathogen anywhere along the urinary tract. UTI has been classified by site of infection as Upper urinary tract infection and lower urinary tract infection and by severity as Complicated and uncomplicated UTI. This community based cross sectional study was conducted to determine the Antibiotic sensitivity pattern and plasmid profile of most prevalent urinary tract infection isolates among children below 10 years of age, from December 2013 to February 2014. Among the total 800 sample collected from the community 390(48.8%) were female and 410(51.2%) were male. The prevalence rate was found to be 44(5.5%) of total cases and was statistically significant (p<0.05). Among significant growth, 15(1.9%) and 29(3.6%) were male and female respectively (p<0.05). Out of 44 total isolates frequency of Escherichia coli (E. coli) was 20 followed by Staphylococcus aureus(12), which accounted for 45.5% and 27.3% respectively. Remaining were Pseudomonas(11.4%), Klebsiella(11.4%), Proteus(2.3%)and Citrobacter sps.(2.3%). Tobramycin(100%) and Amikacin(97.73%) were found to be the most sensitive antibiotics followed by Chloramphenicol(93.18%), Imipenem(90.91%) and Ciprofloxacin(75%) respectively.Out of 20 E. coli isolates, no plasmid was seen in 7(35%) while 8(40%) showed single plasmid which was present in 8 isolates. Plasmid copy number of 2, 3 and 4 were displayed by 2(10%), 2(10%) and 1(5%) of the isolates respectively. A common (>21 kilobases) plasmid was the most common among isolates under study. This study revealed that E. coli was the most prevalent organism causing community acquired pediatric UTI. Antibiotics that are commonly used for the management of UTI and other cases are being more resistant i.e., Ampicillin. Plasmid analysis showed the presence of plasmids in resistant E. coli isolates that might harbor resistant genes. So that further analysis is required for the detection of responsible genes. Key words: Antibiotic sensitivity pattern, Plasmid profile, Urinary tract infection


2020 ◽  
Vol 13 (4) ◽  
pp. 180-183
Author(s):  
Khadija Muneer ◽  
Kaneez Fatima ◽  
Naheed Hashmat ◽  
Sana Humayun ◽  
Qaiser Pervaiz ◽  
...  

ABSTRACT Background: Diabetes mellitus is the fifth leading cause of death in developed countries.Risk of infections is increased in diabetic patients with urinary tract being the most common site of infection. Worldwide, the prevalence of urinary tract infections (UTI) is estimated to be around 150 million persons per year . UTI exhibit a poorer prognosis in patients of type 2 diabetes mellitus (T2DM) due to a compromise in their immune status in addition to emerging antimicrobial resistance due to widespread use of antimicrobial agents. This study aims to determine frequency of common bacterial pathogens causing UTI and antibiotic sensitivity pattern among type 2 diabetic patients. This may help to guide physicians regarding appropriate management of UTI in the local population to avoid multidrug resistance. Patients and Methods: This cross sectional study involved 215 type 2 diabetic patients admitted to Medical Unit-III of Sir Ganga Ram hospital, Lahore from 01-12-2016 to 31-05-2017. Type 2 adult diabetic patients (diagnosed for at least 1 year) of age 40-80 years, either male or female , with urine pus cells ≥5/HPF performed as baseline investigation at admission were included in the study. Further urine samples were obtained (clean catch midstream urine 10cc in two wide mouth sterile screw capped plastic jars) before starting treatment. Samples were sent for microscopy and culture. Culture results and antibiotic sensitivities were recorded. Data was analyzed using SPSS for windows version 23.0. Categorical variables like gender, organisms and antibiotic sensitivitywas presented in Frequency or Percentage form. Numerical variables like age and duration of diabetes were presented as Mean± SD. Data was stratified for age, gender and duration of DM to deal with effect modifiers. Post stratification chi-square test was applied. P-value of ≤0.05 was considered significant. Results: Total of 215 patients were included. Mean age was 63.76±10.342 years of which 164 (76.3%) were females, while 51 (23.7%) were males reflecting female predominance.Most common isolated organism in urine culture was E.coli (58.6%), followed by Klebsiella (20.5%), Proteus(9.3%), Pseudomonas(8.4%) and Enterococcus (3.3%)species.Most of the patients (76.7%) were sensitive to piperacillin-tazobactam followed bycarbapenems (67%) and Gentamycin(56.7%), whereas 24.2% showed sensitivity to all antibiotics. Conclusion: Females are most commonly affected among diabetic patients. The commonest isolate was E.coli among culture positive UTIs. E.coli was most sensitive to piperacillin-tazobactam and carbapenems followed by Gentamycin while least sensitive to Ceftriaxone.The results emphasize the importance of practcse of urine culture and sensitivity testing in diabetic patients and cautious approach to use of commonly used antibiotic ceftriaxone and ciprofloxacin as empirical treatment for UTI despite the low sensitivityof the drug to the most prevailing organism.


Author(s):  
Sunil Shivaputrayya Gidamudi ◽  
Gaurav V Salunke

ABSTRACTObjective: The objective of this study was to find out the etiology of urinary tract infections (UTIs) in patients attending B.K.L. Walawalkar Hospital,Dervan and to determine their antibiotic sensitivity pattern to currently used antimicrobial agents.Methods: A cross-sectional study was conducted in a rural hospital of Konkan Maharashtra, and urine samples were collected from368 clinically - suspected cases of UTIs using the mid-stream “clean catch” method and was tested and cultured using standard procedures. Antimicrobialsusceptibility test (AST) was performed for the isolated pathogens according to the Clinical and Laboratory Standards Institute guidelines.Results: Escherichia coli (54.84%) was the most prevalent uropathogen. 76.47% of the isolated E. coli were found to be extended spectrum betalactamase producers. A higher prevalence rate of resistance was seen among E. coli to the commonly prescribed antibiotic agents. 32 (94.11%) of34 E. coli isolates recovered had multiple antibiotic resistance (MAR), with 16 isolates (50%) possessing MAR indices of 0.6.Conclusion: The study indicates the isolated microorganisms in UTI showed very high resistance to the commonly prescribed antimicrobial drugs.This suggests the monitoring and rational use of the antimicrobial agents.Keywords: Mid-stream, Culture, Uropathogen, Resistance, Multiple antibiotic resistance.


1996 ◽  
Vol 24 (3) ◽  
pp. 296-301 ◽  
Author(s):  
F Jinnah ◽  
M S Islam ◽  
M A K Rumi ◽  
M G Morshed ◽  
F Huq

Escherichia coli was isolated from 65 urine samples out of 300 specimens collected from diabetic and non-diabetic patients with urinary tract infections. All isolates were screened for susceptibility to commonly used antibiotics. No remarkable difference in sensitivity pattern was observed between the E. coli isolates from diabetic and non-diabetic out-patients. However, the isolates from hospitalized diabetic patients showed a clear difference in sensitivity; E. coli from this group was more resistant to commonly used antibiotics compared with those from non-hospitalized diabetic and non-diabetic patients.


Author(s):  
Sandinti Deepa ◽  
V. Lakshmaiah ◽  
Arvind Natarajan ◽  
Prabhakar K. ◽  
Raveesha A.

Background: Diabetes Mellitus is reported to increase the risk of Urinary Tract Infection (UTI) with higher probability of drug resistant organisms. Understanding the burden, microbiological profile and antibiotic sensitivity pattern is vital for effective prevention and management. To assess the microbiological profile and antibiotic sensitivity pattern of Urinary Tract infections among type 2 diabetes mellitus patients.Methods: The study was A prospective observational study done on 117 type 2 diabetic subjects aged above 18 years presenting with symptoms of UTI in a tertiary care hospital Urine was analyzed for urine routine examination, culture and antibiotic sensitivity using standard testing methods on a midstream urine sample. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.Results: The mean age of the study population was 57 years. Females constituted 62.39% of participants. Burning micturition (52.99%) was the most common presenting symptom. The prevalence of culture positive UTI was 51.28%. Among gram-negative bacilli, Escherichia coli (20.51%), Klebsiella (6.85%) dominated the culture reports. Enterococcus (4.27%) and Staphylococcus aureus (2.6%) were the common gram-positive organisms isolated.  Meropenem was the most effective antibiotic against E. coli (87.5%) and Klebsiella (95%) Vancomycin had 100% sensitivity against Enterococci and S. aureus.Conclusions: More than half of diabetic patients presenting with symptoms of UTI had culture positive UTI, predominantly caused by gram negative organisms. There is a need for comparative studies of Diabetes and controls to explore the key differences in the pattern of UTI.


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