The Pattern of Organism Causing Urinary Tract Infection in Diabetic and Non Diabetic Patients in Bangladesh

Urinary tract infection (UTI) is common both in the diabetic and non-diabetic patients. The widespread use of antimicrobial agents leads to emergence of resistant microorganisms. Since the pattern of bacterial resistance is constantly changing, the monitoring of the antimicrobial susceptibilities of the predominantly isolated organisms becomes more important. Aim of this study was to determine the etiologic agents and their antibiotic sensitivity pattern in both diabetic and non-diabetic patients with urinary tract infection (UTI). A total of 288 diabetics (196 female and 92 males) and 63 non diabetic patients (43 female and 20 males) with symptomatic UTI were included in this study. Among the study cases, 43.8% diabetic patients and 42.9% non-diabetic patients had positive growth from urine. Rate of isolation of Escherichia coli in diabetic was less (61.8%) compared to non diabetic (77.8%). Rate of other organisms isolated in diabetic and non diabetic patients were respectively: Klebsiella sp 6.9% vs 3.7%, Enterococcus 12.2% vs3.7%, Pseudomonas species 3.8% vs 0%, Candida species 4.6% versus 3.7%, Staphylococcus aureus 4.6% versus 7.4% etc. E coli isolated from diabetic patient was significantly (p<0.05) less sensitive to ceftriaxone, ceftazidime, cefuroxime, netilmicin, gentamicin, ciprofloxacin and nitrofurantoin than that of non diabetic patients. In addition, isolation rate of the Extended Spectrum Beta Lactamase producing gram negative bacilli was found higher among diabetic population (47.8%) compared to the non-diabetics (9.1%). Key words: Urinary tract infection (UTI), Diabetic and non diabetic patient, Extended Spectrum Beta Lactamase. DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8461 BJMM 2011; 4(1): 6-8

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Frequency of Extended-Spectrum Beta-Lactamase Producing Organisms Causing Urinary Tract Infection and Their Antibiotic Sensitivity Pattern

Journal of Medicine ◽

10.3329/jom.v18i1.31162 ◽

2017 ◽

Vol 18 (1) ◽

pp. 3-5

Author(s):

Md Raziur Rahman ◽

Muhammad Abdur Rahim ◽

Samira Rahat Afroze ◽

Chinmay Shaha Poddar ◽

Khwaja Nazim Uddin

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Antibiotic Sensitivity ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Number Of Patients ◽

Sensitivity Pattern

Background: The spectrum of bacteria causing urinary tract infection (UTI) and their antibiotic sensitivity pattern is not uniform. Escherichia coli and Klebsiella sp. are two common organisms responsible for UTI through-out the world. The incidence of UTI due to infection with extended-spectrum beta-lactamase (ESBL) producing organisms are increasing. This study was aimed to describe the frequency of ESBL positive organisms causing UTI and their antibiotic sensitivity pattern.Methods: This cross-sectional study was done in the Department of Internal Medicine, BIRDEM General Hospital from January to April, 2016.Results: Total number of patients was 137 with females predominance (M:F ratio 1 : 3.7). Mean age was 60.3 ±11.7 years. Most patients (131, 95.6%) of the study population were diabetic and glycaemic control was poor (mean HbA1c 9.3 ±2.3) in these subjects. Common symptoms were fever, vomiting, increased urinary frequency, dysuria, suprapubic pain, and loin pain. Neutrophilic leukocytosis was common (94.9%). E. coli (73.7%) was the commonest aetiological agent followed by Klebsiella (8.8%), Enterococcus (4.4%), Citrobacter (3.6%), Staphylococcus aureus (3.6%), Acinetobacter (2.9%), Enterobacter (1.5%), and Pseudomonas (1.5%). Over half of E. coli and of Klebsiella sp. and 100% of Enterobacter organisms were ESBL positive. Imipenem (100%), amikacin, netilmycin,and nitrofurantoin were among the most sensitive antibiotics.Conclusion: More than half (71, 51.82%) of UTI cases were due to ESBL positive organisms. Imipenem, amikacin, netilmycin, and nitrofurantoin remain the drug of choice.J MEDICINE January 2017; 18 (1) : 3-5

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