scholarly journals Microbiological profile and antibiotic resistance pattern of urinary tract infection in a tertiary care hospital

Author(s):  
Vismaya V. R. ◽  
Naiema Shajihan ◽  
Midhun Ramesh ◽  
Ambika Devi

Urinary tract infection (UTI), of varying severity is one of the most commonly encountered ailments in nephrology outpatient department (OPD). The commonest pathogens causing community acquired UTI (CAUTI) are E. Coli, Proteus mirabilis, Pseudomonas aeruginosa and Klebsiella pneumonia. There is a rapidly rising trend of antibiotic resistance among these uropathogens, may be due to indiscriminate antibiotic usage and poor patient compliance. We conducted a retrospective analysis of all culture proven UTI cases that attended the nephrology OPD of S. K. hospital, Trivandrum from August 2017 to July 2019 (24 months). 130 males and 121 females were included in the study. The mean age of the study group was 62.8 years with a male predominance in the age group above 50 years and a female predisposition in less than 50 years group. Commonest pathogen isolated in urine culture was E. coli (52.98%) followed by Klebsiella (39.09%), Citrobacter (8.76%), Pseudomonas (8.37%), Enterobacter (2.39%), Enterococci (1.99%), Candida (1.59%), Acinetobacter (1.2%), Proteus (1.2%), Streptococci (1.2%) and Serratia (0.4%).

Author(s):  
Mahadev Meena ◽  
Naveen Kishoria ◽  
Durga Shankar Meena ◽  
Vikram Singh Sonwal

Background: UTI is one of the commonest bacterial infection with significant economic burden on the health care system in developing countries like India. Rising antibiotic resistance is a matter of great concern. Aims: The aim of this study was to determine the bacteriological profile and antibiotic resistance pattern in patients with UTI in Tertiary Care Hospital in western Rajasthan India. Settings and Design: A cross-sectional, descriptive study was conducted from December 2017 to November 2018 at MDM hospital S.N. medical college, Jodhpur in western Rajasthan. Materials and methods: All the patients with symptoms of urinary tract infection, presented in the outpatient unit or developed symptoms within 48 hr of hospitalisation were included in the study. Only those patients with significant bacteriuria (105 cfu/ml) were included. Results: The total prevalence of UTI was 55.34% in our study. Most common bacteria isolated in urine sample was E. coli (37.2%) followed by Klebsiella pneumonia (10.2%), Enterococci spp. (3.3%), and Pseudomonas spp. (1.9%). Gram-negative bacteria represented 92.44% of the isolates. E. coli showed maximum resistance towards co-trimoxazole (78.75%) followed by cefuroxime (77.5%) & ciprofloxacin (72.5%). Klebsiella pneumoniae showed the highest resistance against co-trimoxazole (23.75%) and ciprofloxacin (23.75%). Conclusions: The present study gives an idea about the common trend of antibiotic resistance of uropathogens in this region. The findings in our study will help in the formulation of antibiotic policy and determination of empirical treatment of UTI in this region.


Author(s):  
Nandkishor Bankar ◽  
Dhruba Hari Chandi ◽  
Praful Patil ◽  
Gaurav Mahajan

Introduction: UTI occurs when bacteria that live inside intestine find their way into the urinary tract through the urethra. Women are familiar to be a lot of at risk of UTI than men, with a five hundredth probability of a UTI in their life. Aim: The aim of this study was to find the antibiotic resistance pattern in Escherichia coli isolated from urinary tract infection with commonly found antibiotics among different age and sex groups. Materials and Methods: All positive urine samples for Escherichia coli obtained from patients were included. On the basis of colony morphology and biochemical tests Isolates were identified. The antibiogram profile of the isolates was determined by commonly used antibiotics. Result: In this studied, total 250 patients with UTI of both sexes were included and divided into age group. Samples processed only 250 samples with the growth of E. coli were included in this studied. The isolated E.coli showed more resistant to some degree to all the antibiotics tested.  The greatest resistance was shown against Amoxycillin (15.2% isolated were sensitive) and the least resistance was shown against Imipenem (96.4% isolated were sensitive). Conclusion: The pattern of antibiotic resistance varies from place to place, region to region, and country to country. Antimicrobial resistance should be monitored on a regular basis in both the community and hospital settings.


Author(s):  
Shanthi Bamukumar ◽  
Kannan I ◽  
Sukumar Rg

  Objective: The aim is to study the fluoroquinolone resistance pattern among the pathogens causing urinary tract infection (UTI).Methods: This study was done during January to July 2016 in Tagore Medical College including both hospitalized and out patients. During this 7-month study, around 2695 urine samples were analyzed for the evidence of UTI. 718 samples were culture positive. 366 samples showed fluoroquinolones resistance (50.9%). They were screened for all fluoroquinolone drugs by doing antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method as per the Clinical and Laboratory Standards Institute CLSI guidelines.Results: The resistance pattern of different isolates to norfloxacin is Klebsiella pneumoniae - 20%, Escherichia coli - 51.4%, Enterococci - 11.1%, Proteus mirabilis - 50%, and Staphylococcus saprophyticus - 37.5%; For nalidixic acid is K pneumoniae - 25%, E. coli - 6.8%, Pseudomonas aeruginosa - 71.4%, Enterococci - 11.1%, P. mirabilis - 25%, and S. saprophyticus - 25%; For ciprofloxacin is K. pneumoniae - 5%, E. coli - 5.4%, P. mirabilis - 25%, and S. saprophyticus - 25%; and For ofloxacin is K. pneumoniae - 10%, E. coli - 5.4%, Enterococci 11.1%, and S. saprophyticus 62.5%.Conclusion: Due to increasing resistance to fluoroquinolones in many hospitals and to make the developing resistance rates under control, empirical usage of it is either abandoned or should be restricted.


Objective: To determine the spectrum and antibiotic resistance pattern of uropathogens causing urinary tract infection among inpatients and outpatients in a tertiary care hospital in Karachi Methods: This descriptive cross-sectional study was conducted in the Department of Microbiology, Sindh Institute of Urology and Transplant, Karachi, The study was conducted from March 2016 to March 2017 after taking approval from the Hospital Ethics Committee. Urine specimens were analyzed to establish a diagnosis of UTI and identify uropahtogens. The antibiotic susceptibility pattern of uropathogens was studied using disc diffusion method against the following antibiotics; fosfomycin, ampicillin, amoxicillin-clavulanate, nitrofurantoin, cefotaxime, ceftazidime, amikacin, cefoxitin, imipenem and vancomycin. Results: A total of 480 samples of UTI were received during the study period. The average age of patients was 54.79±12.09 years. The majority of samples came out positive from the male gender (65%) and in-patient department (n=400, 83.3%). The highest prevalent microorganism was E.coli (82.1%) followed by Klebsiella spp (14%), Pseudomonas aeruginosa (1%), Proteus mirabilis (1%), Morganella morgannii (1%) and Staphylococcus aureus (0.8%). All microorganisms were highly resistant to augmentin, cefoxitin, cefotaxime, ceftazidime. Only pseudomonas aeruginosa was highly resistant to imipenem (60%). Pseudomonas aeruginosa (100%), E.coli (86.8%) and Klebsiella spp (71.6%) were highly sensitive for Amikacin (100%). Morganella morgannii (80%) and Proteus Mirabilis (40%) were mainly resistant to Fosfomycin. Only E.coli was sensitive to nitrofurantoin (74.1%). Conclusion: The presented study demonstrated that gram-negative bacteria was the most frequent cause of urinary tract infection. Microorganisms showed variable resistance to different antibiotics. The first line of antibiotics should be rationally selected by physicians to treat urinary tract infections.


2021 ◽  
Vol 8 (4) ◽  
pp. 104-112
Author(s):  
Hubza Ruatt Khan ◽  
Mehvish Javeed ◽  
Asghar Javed ◽  
Nisma Farooq

Urinary Tract Infection is alarming problem worldwide due to the intensity of antimicrobial resistance. Escherichia coli is the most predominant organism in UTI. This study was planned to evaluate demographic parameters, the prevalence of E. coli, and antimicrobial resistance patterns among E. coli isolates from UTI patients in Nishtar Hospital of Multan from January to June 2018. A total of 350 mid-stream urine samples were collected from different patients having age group from 25 to 60 years and processed by standard laboratory procedures. Out of 350 samples, 100 samples were observed as critical bacteremia. Escherichia coli and Klebsiella pneumonia were the most persistent (47 % and 19 % individually) among the Gram-negative pathogens followed by S. aureus (14 %), Enterobacter spp. (11 %) and Candida (9 %) respectively. The incidence of UTI was found higher in 25-35 age groups. The prevalence of UTI with E. coli as an infectious agent was 72 % in females, and 28 % in males. The prevalence of E. coli was more in rural areas (70 %) than in urban areas (26 %). The antimicrobial testing against E. coli showed the highest resistance to amoxicillin (65.9 %) and ciprofloxacin (38.2 %), whereas highly sensitive rate observed against Fosfomycin (FOS) (95.7 %), Gentamicin (GEN) (89.3 %), and Nitrofurantoin (NIT) (85 %) respectively. The increased resistance against ampicillin and ciprofloxacin was observed in Multan have a great emerging problem so there is a need for effective prevention strategies for the E. coli drug resistance and successful surveillance required to be improved.


2018 ◽  
Vol 16 (2) ◽  
pp. 178-183
Author(s):  
Dhiraj Shrestha ◽  
Pratigya Thapa ◽  
Dinesh Bhandari ◽  
Hiramani Parajuli ◽  
Prakash Chaudhary ◽  
...  

Background: The study was designed to provide account of etiological agents of urinary tract infection in pediatric patients and the antimicrobial resistance pattern plus biofilm producing profile of the isolates.Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%). Of 64 isolates, 23 (35.93%) were found to be multidrug- resistant strains. Biofilm was produced by 36 (56.25%) isolates.Conclusions: This study showed higher biofilm production and resistance to in-use antibiotics rendering ineffective for empirical use. Regular surveillance of resistance patterns should be done to regulate multidrug- resistant bugs and to ensure effective management of urinary tract infection in children in a tertiary care setups.Keywords: AMR; antimicrobial resistance; biofilm; urinary tract infection; UTI.


2014 ◽  
Vol 2 (03) ◽  
pp. 105-111
Author(s):  
M. Singh ◽  
P. Kothiyal ◽  
P. Mathur

The urinary tract is the most common site of nosocomial infections accounting for more than 40% of the total number reported by acute care hospitals and affecting approximately 600,000 patients per year. Catheter Associated Urinary Tract Infection (CAUTI) defines in terms of “bacteriuria” and “urinary tract infection” frequently. Bacteriuria or funguria levels >103 colony- forming units (CFU) have been shown to be highly predictive of CAUTI, given that these levels increase to 105 CFU within 24 to 48 hours. In Indian population, catheterassociated urinary tract infection (CAUTI) is an important cause of morbidity and mortality, affecting all age groups. Biofilm is the predominant mode of growth in aquatic ecosystems and, as such, plays a central role in the pathogenesis of Catheter Associated Urinary Tract Infections (CAUTI). The present review focuses to evaluate the incidence and pattern of microbes in catheter associated urinary tract infection and provides information about the etiology of CAUTI. Most of the studies concluded that gram negative pathogen E.coli showed the highest incidence rate and other pathogens like Klebsiella pneumonia, Pseudomonas aeruginosa, and staphylococcus species also having the incidence rate in the patient having CAUTI. The antibiotic resistance pattern showed the variation in resistance and sensitivity of antibiotics against the pathogens. The present study focuses on the incidence of the microbial growth in patient having catheterization and also elucidates the antibiotic sensitivity pattern. It is necessary to determine the antibiotic resistance and sensitivity status during and after the catheterization.


Author(s):  
Mohamed Kettani Halabi ◽  
Fatima Azzahra Lahlou ◽  
Idrissa Diawara ◽  
Younes El Adouzi ◽  
Rabiaa Marnaoui ◽  
...  

Extended-spectrum β-lactamases producing Escherichia coli (ESBL-EC) lend resistance to most β-lactam antibiotics. Because of limited treatment options, ESBL-EC infections are generally more difficult to treat, leading to higher hospital costs, reduced rates of microbiological and clinical responses, and a threat to the patient’s life. This study aimed to determine the antibiotic resistance pattern of ESBL-EC isolated from patients with urinary tract infection in Morocco. This retrospective laboratory-based study was conducted at Cheikh Khalifa International University Hospital, Casablanca, from January 2016 to June 2019. A total of 670 urine samples were collected from urinary tract infection patients and processed by standard microbiological methods. In vitro susceptibility testing to different antibiotics of all identified isolates of Escherichia coli (E. coli) was performed following Kirby–Bauer’s disc diffusion method on Mueller–Hinton Agar according to the EUCAST standards. The reviewing of ESBL-EC was confirmed by the appearance of a characteristically shaped zone referred to as a “champagne cork” using the Combined Disk Test. Among a total of 438 E. coli isolated from nonrepetitive urine samples, two hundred fifty-nine (59%) were ESBL-EC, of which 200 (77%) were isolated from adult patients (over the age of 50) and the majority were female. All ESBL-EC isolates were resistant to third-generation cephalosporin and quinolones and sensitive to carbapenem and fosfomycin. Knowledge of antimicrobial resistance patterns in ESBL-EC, the major pathogen associated with urinary tract infection, is indispensable as a guide in choosing empirical antimicrobial treatment.


2016 ◽  
Vol 5 (1) ◽  
pp. 20-23
Author(s):  
Raziur Rahman ◽  
Muhammad Abdur Rahim ◽  
Samira Rahat Afroze ◽  
Palash Mitra ◽  
Tabassum Samad ◽  
...  

Background and Aims: Urinary tract infection (UTI) is a common illness. The spectrum of bacteria causing UTI and their antibiotic sensitivity is not uniform. This study was designed to describe the bacteriological spectrum causing UTI and their antibiotic sensitivity.Methods: This cross-sectional study was done in the Department of Internal Medicine, BIRDEM General Hospital from January to June, 2013.Results: Total number of patients was 103 with females predominance (F:M ratio 2:1). Mean age was 57.5 years. Most (91.3%) of the study population were diabetic with poor glycaemic control (mean HbA1c 9.9%). Common symptoms were fever, dysuria, increased urinary frequency, suprapubic pain, vomiting and loin pain. Neutrophilic leukocytosis was common (94.2%). E. coli (79.6%) was the commonest aetiological agent followed by Klebsiella (9.7%), Citrobacter (3.9%), Acinetobacter (1.9%), Enterobacter (1.9%), Enterococcus (1.9%) and Pseudomonas (0.9%). Imipenem (100%), aminoglycosides e.g. amikacin and gentamycin and nitrofurantoin were among the most sensitive antibiotics.Conclusion: E. coli is the commonest organism causing UTI and imipenem, amikacin and nitrofurantoin are the most sensitive antibiotics.Birdem Med J 2015; 5(1): 20-23


2016 ◽  
Vol 5 (2) ◽  
pp. 51-55 ◽  
Author(s):  
Bigu Kumar Chaudhari ◽  
Ganesh Kumar Singh ◽  
Kamal Prasad Parajuli ◽  
Kewal Shrestha

Background Urinary Tract Infection (UTI) is one of the most common infectious diseases which affect almost all ages groups of population. Production of â-lactamases is responsible for antibacterial resistance which is frequently observed in Enterobacteriaceae isolates, particularly by E. coli and Klebsiella pneumoniae. This investigation has been carried out to determine the current status of prevalence and susceptibility of uropathogens isolated among the patients at tertiary care hospital in eastern Nepal.Material and Methods This study was done at the department of Microbiology, Nobel Medical College Teaching Hospital, Biratnagar, Nepal during May 1st 2015 to October 31st 2015. Midstream cleancatch urine was sampled from 1730 suspected urinary tract infection patients of different age and sex groups. Uropathogens were recognized in term of standard and specific microbiological techniques and antimicrobial susceptibility pattern was determined by Kirby Bauer Disc diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines.Results Out of 1730 suspected specimens Culture resulted a total of 761 (43.98 %) positive and 969 (56.02%) negative among that significant growths of uropathogens including 700 (91.98 %) unimicrobial and 60 (7.88 %) polymicrobial growths. In term of Gender distribution 443 (25.60 %) were male and 1287 (74.40 %) were female hence the ratio is 0.34:1, respectively. E. coli was the leading isolate (66 %), followed by Klebsiella spp. (12 %), Enterococcus spp. (8 %), Pseudomonas spp. (6 %), Acinetobacter anitratus (5 %), Proteus spp. (3 %).Conclusion The high frequency of multidrug resistance in bacterial uropathogens was seen. Principally, resistance patterns were seen higher for amoxycillin, co-trimoxazole, flouroquinolones and third-generation cephalosporins, Existing uropathogens highlights the highest rate of vulnerability to nitrofurantoin, amikacin and gentamicin which provide much better antibiotic coverage and can be adapted for practical treatment of urinary tract infections.  Journal of Nobel Medical College Vol.5(2) 2016; 51-55


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