scholarly journals Comparison of empirical antibiotics used with microbiological sensitivity pattern among patients admitted with urinary tract infection

Author(s):  
Sanal K. Thomas ◽  
V. Abraham Varghese

Background: Symptomatic Urinary tract infection (UTI) is among the most common infection described in hospital settings. Inappropriate use of antibiotics initiated before the laboratory results of urine culture contribute to increasing resistance to antibiotics in uropathogens. Awareness of the disease, knowledge of the spectrum of antibiotics and common complication of UTI will help to reduce morbidity and mortality. This study compares common empirical antibiotics used with their  clinical outcomes and microbiological sensitivity pattern among patients admitted with UTI in a tertiary care hospital.Methods: It is a cross sectional study conducted in inpatients of Pushpagiri medical college, Thiruvalla from January 2017 – June 2018. Assuming that 50% of organisms will show sensitivity to empirical antibiotic therapy with a relative precision of 20% and alpha error of 5 %. Sample size is calculated as 100. Those patient  satisfying the inclusion criteria was recruited into the study after obtaining informed consent till the sample size attained. Symptoms on the day of admission was assessed using the questionnaire for Clinical profile. Primary outcome was matching of empirical antibiotics with culture and sensitivity pattern.  Secondary outcomes were Symptom resolution on third day with empirical antibiotics and profile organisms causing UTI.Results: Majority of the population belonged to 61-80 year of age (57%). The study population had 44 percent male and 56 females.72 percent of total population was diabetic.  The most common antibiotic used to treat empirically was piperacillin –tazobactum accounting for 47.2 percent followed by ceftriaxone  45 percent. Others contributed less than 8 percent.75 percent of empirical antibiotics matched with culture and sensitivity report in the study population.The most common organisms found was Escherichia coli (61%) followed by Klebsiella pneumonia(15 %) The most common resistant organism was E Coli followed by Klebsiella pneumonia. Esbl resistance was encountered in 28 cases and carbepenamase resistance in 2 percent cases. 27 percent of diabetic patient had resistant organism infection in urine. Symptoms  of  urinary tract infections were better resolved when empirical antibiotics used had  matched microbiological sensitivity pattern.Conclusions: After the age of 60 year UTI occurred almost equal in male and females There was only 75 percent agreement with empirical antibiotics and culture sensitivity report. Resistant organism were common in the diabetic population. Most common organism encountered in symptomatic UTI is E coli. Symptomatic resolution occurred in majority of cases where the empirical antibiotic was sensitive than compared to resistant case. Some of the resistant cases had symptomatic resolution  possibly explained by the in vivo sensitivity. As the agreement with empirical antibiotics became low, hospital antibiotic policies must reviewed and changed according to resistance pattern and type of organism that is locally prevalent

2019 ◽  
Vol 9 (4) ◽  
pp. 18-23
Author(s):  
Arun Sedhain ◽  
Abja Sapkota ◽  
Bidhan Shrestha

Background: Urinary tract infection (UTI) is characterized by pathological invasion of the urinary tract by microorganisms. Majorities of organisms causing UTI are gram negative bacteria, most common of which is E. coli. Urine culture and sensitivity test is used to isolate the organism and to identify the susceptible drug of choice for appropriate treatment. This hospital-based study was carried out to analyze the spectrum and antibiotic susceptibility of microorganisms causing UTI. Methods: A retrospective study was done to analyze the results of urine culture and sensitivity test done at Chitwan Medical College Teaching Hospital over a period of two and half years. Standard guideline and protocol were used to collect the urine sample and to perform the test. Data analysis was done using SPSS version 21.0. Result: Out of 12, 925 urine samples submitted for culture and sensitivity test during the study period, bacterial pathogens were isolated from 3, 173 (24.54%) samples, which was significantly higher among females (28%) than the males (17%). The most common organism isolated on the culture was E. coli (68.5%) followed by Klebsiella (18.4%). Sensitivity of the uropathogens was seen highest with colistin (79.2%) followed by teicoplanin (64.58%), Aztreonam (63.25%) and Ni­trofurantoin (61.16%). Most common antibiotics that showed resistance to the microorganisms in this study were Ampicillin (60.93%), Cotrimoxazole (53.72%), Cefixime (40.57%) and Levofloxacin (32.93%). Conclusions: This study has found a usual pattern of UTI with higher prevalence among females and E. coli being the most common organism. Nitrofurantoin has been found to have a good sus­ceptibility for the treatment of UTI.


2021 ◽  
Vol 15 (7) ◽  
pp. 1868-1872
Author(s):  
Hakim Ali Abro ◽  
Sheeraz Ali ◽  
Sultan Ahmed Chandio ◽  
Jamil Muqtadir ◽  
Mumtaz Ali Chutto ◽  
...  

Objective: To study the pattern of existing common pathogen of Urinary Tract Infection and their drug sensitivity pattern. Methods: It was a cross sectional study held in Medical Unit-I, CMC Teaching Hospital, Shaheed Mohtarma Benazir Bhutto Medical University(SMBBMU), Larkana with collaboration of Pathology Laboratory CMC Larkana, Aga Khan University Hospital Lab, Rahila Research Lab and Chughtai Lab. All the participants meeting inclusion criteria were enrolled. The reports of Urine culture were collected from above mentioned laboratories which include bio data, causative organism, their count and drug sensitivity pattern. The results were copied on proforma by researcher himself. SPSS version 25 was applied for data analysis. Results: Total 302 participants were registered in the study. Out of them 75.8% of them were female and 24.2% were male. Mean age of the patients was 40 ± 9 years. E-coli was found in 52.3%, Enterococcus in 13.2% and Klebsiella pneumonia in 9.6% cases. Meropenem was found sensitive in 92.4%, while cefoperazone sulbactam, Amikacin and Fosfomycin were found to be sensitive in 86.6%, 85%, 76.2% respectively. Ampicillin and Vancomycin was used in 50 cases for Enterococci. Ampicillin was found sensitive in 70% of cases where as vancomycin was found sensitive in 100% of cases with no vancomycin resistant Enterococci. For Enterobacteria Moxifloxacin was found resistant in 84.4% of cases, Ampicillin in 83.5%, Nalidix acid in 78% cases. While Ceftazidime and Amoxiclav was found resistant in 71.1% and 54.1% respectively. Conclusion: E-coli, Enterococcus and klabsella were the most pathogens found in this study. The drug sensitivity pattern showed that Meropenem, Cefoperazone Sulbactam, Amikacin, Fosfomycin and Vancomycin were found commonly sensitive while Moxifloxacin, Ampicillin, Ceftazidime and Amoxiclav was found resistant. Keywords: Urinary Tract Infection, Culture and Sensitivity, Meropenem, Vancomycin, Cefoperazone Sulbactam CMC @ SMBBMU, Larkana.


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):  
Uttam K. Das ◽  
Prithul Bhattacharjee ◽  
Shubhaleena Debnath ◽  
Maitrayee Chakraborty ◽  
Ranjib Ghosh ◽  
...  

Background: Urinary tract infection (UTI) being one of the most common and a serious health problem both in the community and hospital settings each year worldwide, the emergence of antibiotic resistance in the management of UTI is a serious public health issue. The present study will analyse the antimicrobial sensitivity pattern of pathogens isolated from the urine samples of admitted patients suffering from UTI in Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital (TMC).Methods: This was a hospital record-based study. The urine samples of clinically diagnosed UTI patients admitted in various departments of the hospital during the study period were included. The reports of culture and sensitivity testing of the samples were collected. The results were interpreted according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI).Results: During the 12-month study period, a total of 752 urine samples were analysed. Enterococcus (43.75%) was the most frequently isolated bacteria, followed by E. coli (28.45%) and Klebsiella (14.89%). Enterococcus was highly sensitive (p<0.001) to vancomycin (95.33%), E. coli was mostly sensitive to nitrofurantoin (83.65%) and Klebsiella mainly sensitive to imipenem (75.49%).Conclusions: The study showed that positive urine culture with the antibiotic sensitivity of the isolates is very important for antimicrobial therapy, as antibiotic resistance is a worldwide problem which causes ineffectiveness of treatment.


2019 ◽  
Vol 6 (5) ◽  
pp. 1814
Author(s):  
Senthil Kumar A. ◽  
Thannoli Gowthami Gowrinathan

Background: Infections are more common in malnourished children, as result of impaired immunity. Unexplained fever and failure to thrive are the common presenting features of urinary tract infection (UTI) in children. In malnourished children, UTI is mostly asymptomatic and is leading to pyelonephritis and renal scarring. The study was done with the aim to evaluate and find out the prevalence of urinary tract infection in malnourished children between 6 months to 5 year and to find out the causative organism and antibiotic sensitivity pattern.Methods: A total of 180 cases of malnourished children were enrolled and clean catch midstream urine sample was collected for urine culture, according to WHO criteria of malnutrition. Children with urinary tract abnormality were excluded from the study. Renal USG was done in all urine culture positive cases.Results: Total of 174 cases was present after exclusion. Of 174 children, 27 (15.5%) children were having UTI. In this study, 37% of children are asymptomatic. E. coli is the commonest organism causing UTI 16 (59%). Other organism are Klebsiella pneumonia 4 (14.9%), Proteus mirabilis 3 (11.1%), and Pseudomonas 3 (11.1%). The order of antimicrobial sensitivity pattern was amikacin (100%)> ciprofloxacin (81.4%)> cefotaxime (7%). Other common drugs have developed resistance to these organisms.Conclusions: Our observations conclude that malnourished children with fever of unknown origin are at risk of UTI. Hence, urine analysis and culture tests are to be done to all malnutrition cases for assisting to diagnose the bacterial infection and providing the appropriate treatment.


Author(s):  
Jubina Bency A. T. ◽  
Priyanka R. ◽  
Ponnu Jose

Background: Urinary tract infection is one of the most common bacterial infections in humans and a major cause of morbidity. The etiology of UTI and the antibiotic sensitivity pattern varies with the widespread availability of antimicrobial agents; UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents.Methods: A descriptive study done during January-June 2013. All positive urine culture and sensitivity reports of males and females aged 20-70years were included. A total of 373 positive urine culture cases were taken from the culture and sensitivity register from Microbiology department and details were entered using a questionnaire.Results: Out of 373 adults, males were 137 (36.7%) and females were 236 (63.3%). E. coli (74.3 %) was the most common organism, followed by Klebsiella (15.8%), Enterococcus, Pseudomonas and Staphylococcus. The incidence of UTI was more in patients in the age group of 60-70years. E. coli and Klebsiella were sensitive to Amikacin (97.1%), Nitrofurantoin (90.7%), Gentamycin and Imipenem. Both organisms were resistant to Ampicillin (>90%).Conclusions: In this study, females were mostly affected and the most common organisms were E.Coli and Klebsiella. These organisms were most sensitive to Amikacin, Nitrofurantoin and resistant predominantly to Ampicillin. The sensitivity and resistance pattern of uropathogens to common antimicrobial agents must be taken into account when selecting treatment plans for UTI.


2018 ◽  
Vol 30 (1) ◽  
pp. 61-65
Author(s):  
Md Abdul Bari ◽  
Mashiur Arefin ◽  
Moriom Nessa ◽  
Golam Mostofa ◽  
Tafiqul Islam

The objective of the study is to assess the recent sensitivity pattern of Escherichia coli in Urinary tract infection (UTI). Widespread use of antibiotics has led to the emergence of resistant microorganisms. As the antibiotic sensitivity patterns of the microorganisms are frequently changing, this retrospective analysis was designed to assess the recent antibiotic sensitivity pattern of Escherichia coli (E. coli) in urinary tract infection among the human population. Details of 358 urine culture positive reports for E. coli and their antibiotic sensitivity pattern pertaining to the study period of 6 months from Jan 2017 to June 2017 were collected from Microbiology Laboratory of Diagnostic Centers at Rajshahi and the results were statistically analyzed. The antibiotics tested for sensitivity were amikacin, gentamycin, ciprofloxacin, levofloxacin, cotrimoxazole, nitrofurantoin, ceftazidime, ceftriaxone and cefixime. The sensitivity pattern of E.coli to antibiotics in UTI was amikacin (82.68 gentamycin (75.97%), nitrofurantoin (70.67), levofloxacin (44.13%), ceftazidime (42.17%), co-trimoxazole (40.78%), ceftriaxone (38.54%), ciprofloxacin (35.75%), and cefixime (24.02%). The study highlighted the marked resistance of E. coli to quinolones and third generation cephalosporins.TAJ 2017; 30(1): 61-65


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


2019 ◽  
Vol 6 (5) ◽  
pp. 1818
Author(s):  
Dharmalingam Angamuthu ◽  
Chandru Bhaskar ◽  
Nalini Aswathaman

Background: Urinary tract infections (UTIs) are a common cause of acute bacterial illness in infants and children(1).Diagnosis is often missed in infants and children as urinary symptoms are minimal and nonspecific. It is becoming increasingly difficult to treat due to increasing prevalence of antimicrobial resistance among organisms.Method: It was done as a retrospective cross sectional study conducted on Children of 2-12 years of age suspected to have UTI  from January 2018 to December 2018 in Pediatric Department of AVMCH.Results: Out of 286 children with symptoms suggestive of Urinary tract infection, 22(7.7%) were found to have culture positive UTI with 9.2% prevalence in 2-6 years age group as against 6.4% in 7-12 years of age group. Culture positive UTI was predominantly found in males in 2-6 years age group as against female predominance in 7-12 years age group. E. coli (45.5%) was the commonest organism isolated among them followed by Klebsiella. 90% of organisms were sensitive to Nitrofurantoin  and 80% were sensitive to Amikacin(80%).Discussion: Culture positive UTI  rate varies with gender and age group. It was predominantly found in males in 2-6 years age group as against female predominance in 7-12 years age group. E. coli and Klebsieella were the most common organisms with predominant sensitivity to Nitrofurantoin and Amikacin similar to other studies. Limitation of this study Retrospective study, small sample size and follow up for complications not done.Conclusion: This study concludes E. coli and Klebsieella were the most common organisms with predominant sensitivity to Nitrofurantoin and Amikacin. Antibiotics need to be selected based on organisms and their sensitivity pattern.


2020 ◽  
Vol 33 (1) ◽  
pp. 54-58
Author(s):  
N Naher ◽  
F Begum ◽  
N Hashem

Background: Urinary tract infection (UTI) is common during pregnancy and especially soin pregnant patients with diabetes mellitus. The emergence of drug resistance and particularlythe extended spectrum Beta-lactamase production by Escherechia Coli and Methicillinresistance in staphylococci, limits the choice of anti-microbials. Method: A cross-sectional study was conducted on 50 pregnant women with sign andsymptoms of UTI in the Department of Obstetrics and Gynaecology, BIRDEM generalHospital-2 from January to June 2017. The objectives of the study were to determine thepresence and type of pathogens found in pregnant diabetic women presenting with featuresof urinary tract infection, and to analyze their antibiotic sensitivity pattern. Clean catch midstreamurine samples were collected using standard procedure and culture and sensitivitywas done following standard bacteriological method. Results: Mean age of the study subjects was 29.84±5.29 yrs; 48% were in third trimester ofpregnancy; 52% had Gestational Diabetes Mellitus (GDM) and 48% had Diabetes Mellitus(DM). Out of fifty pregnant women, thirty eight (76.0%) study subjects had positive growth.Of them, Escherechia coli was found in 57.9% cases, Klebsiellain 21.1%, Staphylococcusaureus in 7.9%, Enterococcus and Pseudomonas aeruginosa each in 2.6% case. Amikacinwas found to be sensitive to 100% cases of E. Coli, Klebsiella& Enterococcus but 100%resistant to Streptococcus. Conclusion: In this study, E. Coli was the most common organisms causing UTI, which isless susceptible to conventional oral antibiotics but more susceptible to amikacin. So carefulldrug selection is required for successful outcome in UTI. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 54-58


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