Evaluation of antimicrobial resistance pattern of uropathogens in a tertiary care hospital in Dhaka city, Bangladesh

Urinary tract infection (UTI) is one of the most common bacterial infections seen in developing countries like Bangladesh. This study is, therefore, designed to determine the bacterial uropathogens and their antibiotic resistance pattern among patients with complaints of UTIs in Dhaka city. This study was carried out in the laboratory of the Department of Microbiology, Bangladesh Medical College, Dhaka, Bangladesh from January to June 2015. A total of 2541 urine samples were collected in sterile containers from suspected urinary tract infected cases. A specimen was considered positive for UTI if an organism was cultured at a concentration of ≥105CFU/ml or when an organism was cultured at a concentration of 104CFU/ml and >5 pus cells per high power field. Antimicrobial susceptibility testing of the isolated bacterial species was performed by disc diffusion method following the National Committee for Clinical laboratory Standards (NCCLS) guidelines. A total of 303 (11.92%) bacterial uropathogens were isolated from 2541 urine samples. Among the 303 isolates, majority of the isolates 197 (65.02%) were from females. Both the age groups up to 18 years and above 18 years the highest prevalence was found in females 34(11.22%) and 163 (53.79%) respectively. Most predominant organism was Escherichia coli 262(86.46%)followed by Pseudomonas 12(3.96%), Enterococci 12(3.96%), Klebsiella11(3.63%). Escherichiacoli showed very high resistance to amoxycillin 95.41%, cefradin 90.45%, nalidixic acid and Klebsiella to amoxycillin 90.90%, nitrofurantoin 90.90%. Again Pseudomonas was highly resistant to cefuroxime 100%, cefexime 100%and ceftriaxone 83.33%. Enterococci were found highly resistance to cefexime 91.66%, cloxacillin 83.33%, and erythromycin 83.33%.Due to wide scale resistance of the drugs used to treat UTI, choice of drugs in the treatment of UTI is quite narrow. In country like ours awareness for prevention of UTI should be encouraged among the community level as it affects all age groups.South East Asia Journal of Public Health Vol.7(2) 2017: 12-18

Download Full-text

Antimicrobial Sensitivity Pattern of the Common Uropathogens among Patients Admitted in A Tertiary Care Hospital in Bangladesh

Journal of Medicine ◽

10.3329/jom.v21i2.50212 ◽

2020 ◽

Vol 21 (2) ◽

pp. 93-97

Author(s):

AKM Humayon Kabir ◽

SK Jakaria Been Sayeed ◽

Prodip Kumar Biswas ◽

SM Hafiz ◽

Md Uzzwal Mallik ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Bacterial Infections ◽

Tertiary Care ◽

Diffusion Method ◽

Care Hospital ◽

College Hospital ◽

Male Adult ◽

Sensitivity Pattern

Urinary tract infection is one of the most common bacterial infections seen in clinical practice both in developed and developing countries. The causative agents of Urinary tract infection vary from place to place and they also vary in their susceptibility and resistance patterns. This descriptive study aimed to evaluate the antibiotic susceptibility patterns of pathogens isolated from routine laboratory specimens at Dhaka Medical College Hospital. A descriptive cross- sectional study was done from January 2018 to June 2018. A total of 100 mid-stream urine samples from the suspected UTI patients were tested microbiologically and antimicrobial susceptibility test were performed for the isolated pathogens using Kirby-Bauer disk diffusion method with positivity rate of UTI was 90% (90/100). Escherichia coli (39%) was the most UTI causing bacteria followed by Klebsiella 18(18%), Acinetobacter 12(12%), Staphylococci, 9 (9%), Pseudomonas 6 (6%), Enterococcus species 3 (3%) and Proteus 3 (3%). Female 83 (83%) were more affected in comparison with male. Adult female especially age range 18-30 years were found in high risk. Nitrofurantoin, Amikacin and Meropenem were recorded as most sensitive antibiogram for most of the bacteria’s whereas cephalosporin showed increased resistance. However, for uncomplicated community acquired UTI, Nitrofurantoin (oral) and Amikacin (Injectable) can be chosen as first line medication. J MEDICINE JUL 2020; 21 (2) : 93-97

Download Full-text

FLUOROQUINOLONE RESISTANCE PATTERN AMONG THE PATHOGENS CAUSING URINARY TRACT INFECTION IN A TERTIARY CARE HOSPITAL IN KANCHIPURAM DISTRICT, TAMIL NADU, INDIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i11.20678 ◽

2017 ◽

Vol 10 (11) ◽

pp. 292

Author(s):

Shanthi Bamukumar ◽

Kannan I ◽

Sukumar Rg

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Tamil Nadu ◽

Tertiary Care ◽

Fluoroquinolone Resistance ◽

Diffusion Method ◽

Resistance Pattern ◽

Care Hospital ◽

E Coli

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.

Download Full-text

Spectrum and Antibiotic Resistance Pattern of Bacteria Causing Urinary Tract Infections (UTI) in a Tertiary Care Hospital

Journal of Surgical Sciences ◽

10.3329/jss.v23i1.44239 ◽

2020 ◽

Vol 23 (1) ◽

pp. 13-18

Author(s):

Sadia Afroz ◽

Zakir Hossain Habib ◽

Syed Muhammad Baqui Billah ◽

Hasina Akhter ◽

Hosne Jahan ◽

...

Keyword(s):

Urinary Tract ◽

Bacterial Infections ◽

Antimicrobial Agents ◽

Current Knowledge ◽

Clinical Sample ◽

Evaluation Studies ◽

Tertiary Care ◽

Resistance Pattern ◽

Care Hospital ◽

Tract Infections

Background: Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians particularly in developing countries. Current knowledge on antimicrobial resistance pattern is essential for appropriate therapy. The aim of the present study was to identify the causative organisms for UTI and to determine the antibiotic susceptibility pattern of organisms causing UTI. Method: This cross sectional study was carried out in the department of Microbiology, Sir Salimullah Medical College, Dhaka, from a period of January 2014 to December 2014. Results: Out of 2136 clinical sample of urine, 430 (20.1%) showed significant bacterial growth. Escherichia coli was the commonest urinary pathogen (76.3%), followed by Pseudomonas spp. (7.9%), Proteus spp. (7.2%), Klebsiella spp., Citrobacter spp. (1.9% each) and Staphylococcus aureus (1.6%). Isolated uropathogens showed highest resistance for Amoxycillin (86%-97%) and Cefradin (71%-100%), resistance rate for other commonly used antimicrobial agents was high; Cefixime (52%-85%), Ceftriaxone (50%-71%), Ciprofloxacin (50%-88%), Cotrimoxazole (50%-75%), Gentamicin (57%-75%) and Nitrofurantoin (43%-100%), while uropathogens were least resistant to Imipenem (0%-15%) and Amikacin (0%-29%). Conclusion: Due to high degree of resistance to commonly used antimicrobials to treat UTI, routine monitoring and evaluation studies should be conducted to update physicians’ knowledge about most effective antibiotics for treatment of UTI. Journal of Surgical Sciences (2019) Vol. 23 (1) : 13-18

Download Full-text

Changing prevalence and antibiotic drug resistance pattern of pathogens seen in community-acquired pediatric urinary tract infections at a tertiary care hospital of North India

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_149_16 ◽

2017 ◽

Vol 9 (04) ◽

pp. 264-268 ◽

Cited By ~ 6

Author(s):

Vrushali Patwardhan ◽

Dinesh Kumar ◽

Varun Goel ◽

Sarman Singh

Keyword(s):

Urinary Tract ◽

Tertiary Care ◽

Diffusion Method ◽

Resistance Pattern ◽

Antibiotic Administration ◽

Care Hospital ◽

Drug Resistance Pattern ◽

Antibiotic Drug ◽

Tract Infections ◽

Urine Specimens

Abstract INTRODUCTION: Timely treatment of urinary tract infection (UTI) with appropriate antibiotic administration is of immense importance in children to reduce the consequences. AIMS AND OBJECTIVES: The aim and objective of this study was to assess the temporal changes in the microbiological profiles and antimicrobial resistance patterns of uropathogens in pediatric community-acquired UTI. MATERIAL AND METHODS: This is a retrospective analysis of data collected over a Scattered period of 5 years. The baseline data collected were from January to December 2009, and the second period considered for comparison was from January to December 2014. Urine specimens from children (<17 years) suspected of UTI were cultured by a semi-quantitative method on cysteine lactose electrolyte-deficient medium. Antibiotic sensitivity was put up by Kirby–Bauer disc diffusion method as per the Clinical and Laboratory Standard Institute guidelines. RESULTS: In the year 2009, 340 of 2104 (16.15%) urine specimens yielded significant colony count, whereas in 2014, it was 407 of 2212 (18.39%) (P = 0.051). Escherichia coli was the predominant pathogen and was significantly more prevalent in girls than in boys (P < 0.0001) during both periods. There was a significant overall increase in resistance to ampicillin (from 40.29% to 58.72%), amoxyclav (from 26.17% to 40.54%), nitrofurantoin (from 28.82% to 39.06%), and norfloxacin (from 30% to 41.42%). However, the maximum increase in the resistance was noted for co-trimoxazole from 35.58% in 2009 to 63.39% in 2014 (P = 0.0000058). The prevalence of extended-spectrum beta-lactamases (ESBLs) has also significantly increased from 21.7% to 33.16% (P = 0.0045). CONCLUSION: Although E. coli remains the prime pathogen in pediatric UTI, the prevalence of resistance has dramatically increased over the 5-year study period. Our study highlights the emergence of community-acquired ESBL-producing uropathogens in children proclaiming treatment challenges.

Download Full-text

Nasal Carriage of Methicillin Resistant Staphylococcus aureus Among Health Care Workers At Tertiary Care Hospital In Dhaka.

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v11i2.51678 ◽

2017 ◽

Vol 11 (2) ◽

pp. 17-19

Author(s):

Rahima Akter ◽

Shikha Paul ◽

Akhtarun Naher ◽

Moshiur Rahman ◽

Sharmin Sultana ◽

...

Keyword(s):

Tertiary Care ◽

Nasal Carriage ◽

Healthcare Personnel ◽

Diffusion Method ◽

Resistance Pattern ◽

Dilution Method ◽

Care Hospital ◽

Disc Diffusion ◽

Disc Diffusion Method ◽

Mannitol Salt Agar

Nasal carriage of MRSA among hospital stuff act as a source of endogenous infection and becomes a source for hospital and community acquired infection. The study was conducted to determine the rate antibiotic resistance pattern of nasal carriage of MRSA among the hospital stuff of Sir Salimullah Medical College and Mitford Hospital, Dhaka. Pre moistened nasal swabs from hospital stuff (doctor, nurses, lab technicians and other helping stuff were obtained. These swabs were inoculated into Blood agar and Mannitol salt agar media. Antibiogram was done by modified Kirby Bauer disc diffusion method. MRSA were detected by oxacillin and cefoxitin disc diffusion method. The resistance was confirmed by MIC of oxacillin agar dilution method. Out of 142 samples 34 strains of Staphylococcus were isolated among them 07 (4.93%) were MRSA and 27 (19.01%) were MSSA. The carriage rate of MRSA was higher among nurse than other healthcare provider. Nasal carriage of MRSA is responsible for spreading infection from healthcare personnel to normal individual. So, regular screening of carrier is required from prevention of hospital acquired infection. Bangladesh J Med Microbiol 2017; 11 (2): 17-19

Download Full-text

PSEUDOMONAS SPECIES CAUSING URINARY TRACT INFECTION AND ITS ANTIBIOGRAM AT A TERTIARY CARE HOSPITAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i11.20002 ◽

2017 ◽

Vol 10 (11) ◽

pp. 50

Author(s):

Shobha Kl ◽

Ramachandra L ◽

Amita Shobha Rao ◽

Anand Km ◽

Gowrish Rao S

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Urine Samples ◽

Automated System ◽

Care Hospital ◽

Pseudomonas Species ◽

Significant Bacteriuria

Objectives: Pseudomonas species cause urinary tract infection (UTI). This study was conducted to isolate Pseudomonas species causing significant bacteriuria and to analyze its antibiogram at a tertiary care hospital.Methods: About 107 urine samples received in the laboratory from August 2015 to July 2016 having significant bacteriuria with Pseudomonas species were tested for antimicrobial activity. Samples were from both inpatients and patients attending as outpatients to a tertiary care hospital with different age groups and gender. Midstream urine samples were inoculated using a standard calibrated loop into blood agar and MacConkey agar following semi quantitative technique using Kass concept. MALD (Biomerio, ElToile, France) was used for speciation, and Vitex automated system (Biomerio, ElToile, France) was used for antibacterial sensitivity testing.Results: About 107 urine samples contained Pseudomonas species by MALDI obtained from 69 male (64.48%) and 38 (35.51%) female patients. Inpatients were 90 (84.11%) and 17 (15.88%) outpatient department (OPD) patients. Isolation of Pseudomonas aeruginosa was from 90 samples (84.11%) and Pseudomonas putida in 17 (15.88%). Significant bacteriuria was more in the age group of ˃60 years in both genders. Susceptibility to gentamicin was 52 (48.59%), ceftazidime 56 (52.33%), and imipenem was 58 (54.20%). Organism was multidrug resistant in 49 (45.79%) samples.Conclusion: P. aeruginosa remains the most common uropathogen among Pseudomonas species. Drug of choice for inpatients suffering from UTI by Pseudomonas species can be gentamicin and for patients attending OPD can be ceftazidime. Imipenem can be the reserve drug. Periodic antibiotic review is required for proper treatment of UTI.

Download Full-text

Phenotypic and genotypic characterization of multidrug-resistant isolates from patients with catheter-associated urinary tract infection in a tertiary care hospital

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_22_19 ◽

2019 ◽

Vol 11 (03) ◽

pp. 206-211

Author(s):

Jaison Jayakaran ◽

Nirupa Soundararajan ◽

Priyadarshini Shanmugam

Keyword(s):

Urinary Tract ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Diffusion Method ◽

Care Hospital ◽

Disk Diffusion Method ◽

Carbapenem Resistant ◽

Tract Infections

Abstract INTRODUCTION: Urinary tract infections (UTIs) remain as the most common infection. Catheter-associated (CA) UTI can lead to bacteremia and thereby is the leading cause of morbidity and mortality in hospitalized patients in our country. AIMS AND OBJECTIVES: This study aims to check the prevalence of CAUTI and study the phenotypic and genotypic characters of the multidrug-resistant organisms in a tertiary care hospital, with special reference to NDM-1 and OXA-23. MATERIALS AND METHODS: A total of 231 urine samples from patients with CA-UTI in different wards in a tertiary care hospital over a period of 3 months between June and August 2018 were collected and processed following the standard protocol. Antibiotic susceptibility tests were performed by disk-diffusion method. Modified Hodge test (MHT) was done to isolate carbapenem-resistant isolates, and polymerase chain reaction was done to detect NDM-1 and OXA-23. RESULTS: Out of 231 samples, 101 samples yielded significant growth. These 38 samples were Gram-negative bacilli which were resistant to carbapenems. Out of the 38 which showed carbapenem resistance, 23 were MHT positive. Out of the 23 MHT-positive isolates, 8 (21.05%) were positive for NDM-1 gene and only 1 (2.6%) was positive for the OXA-23 gene. CONCLUSION: This study has shown that carbapenem-resistant isolates from all the CA urinary tract-infected patients were 52.77% and most of them were Klebsiella. About 21% of them harbored the NDM-1 gene whereas only 2% had the OXA-23 gene. There has been an alarming increase in the spread of carbapenem resistance.

Download Full-text

Prevalence and Antibiogram of Bacterial Uropathogens of Urinary Tract Infections from a Tertiary Care Hospital of Bangladesh

Journal of Scientific Research ◽

10.3329/jsr.v9i3.31677 ◽

2017 ◽

Vol 9 (3) ◽

pp. 317-328 ◽

Cited By ~ 3

Author(s):

S. A. Sanjee ◽

M. E. Karim ◽

T. Akter ◽

M. A. K. Parvez ◽

M. Hossain ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Tertiary Care ◽

Age Groups ◽

Diffusion Method ◽

Multi Drug Resistance ◽

Care Hospital ◽

Resistance Patterns ◽

Tract Infections ◽

Antibiotic Resistance Patterns

Urinary tract infections (UTIs) are one of the most frequently occurring infections majority of which are caused by multi-drug resistant (MDR) uropathogens. Hence, the present study was designed to find out the prevalence of bacterial pathogens causing UTIs and to determine their antibiotic resistance patterns against different classes of antibiotics. Clean-catch midstream urine samples were collected from 200 UTI patients of different sex and age groups. The uropathogens were isolated using Hi-Chrome UTI agar, Blood agar, MacConkey agar and then subjected to antibiotic susceptibility analysis against nine antibiotics of different classes using Kirby-Bauers disc diffusion method. From 55.08% positive samples, it was found that females were more prone to UTIs than males and in both cases; the prevalence rate was higher in the age group 21-40 years (33%). Among the uropathogens, E.coli was the predominant etiological agent (57.38%) followed by Enterococcus sp. (36.06%), Pseudomonas aeruginosa (3.28%) and Staphylococcus aureus (3.28%). The pathogens showed remarkable amount of sensitivity against Gentamicin and Ciprofloxacin. The present experiment can be helpful for the clinicians in finding proper drugs in the developing countries like Bangladesh where multi-drug resistance problem has just complicated the treatment of UTIs.

Download Full-text

A study on the bacterial isolates from blood cultures of a tertiary care hospital

IP International Journal of Medical Microbiology and Tropical Diseases ◽

10.18231/j.ijmmtd.2021.036 ◽

2021 ◽

Vol 7 (3) ◽

pp. 171-174

Author(s):

KMS Mohamed Ali ◽

K Girija

Keyword(s):

Tertiary Care ◽

Bloodstream Infections ◽

Diffusion Method ◽

Resistance Pattern ◽

Care Hospital ◽

Bacterial Isolates ◽

Tertiary Care Centre ◽

Sensitivity Testing ◽

Cross Sectional ◽

Blood Samples

Blood stream infections are the most important and common cause of morbidity and mortality in tertiary care hospitals. Since the results are usually not available promptly a knowledge of epidemiologic and antimicrobial susceptibility pattern of blood pathogens is life saving and very useful for early treatment and recovery of patients. The aim of this study is to describe the epidemiological, bacterial profile and antimicrobial resistance pattern of bloodstream infections in a tertiary care centre.A prospective cross-sectional study was done on seven hundred and eight blood samples collected over a period of six months in the Microbiology laboratory. Blood samples collected under aseptic conditions were cultured by aerobic culture method. Identification of bacterial isolates were done using standard bacteriologic and biochemical testing methods and antibiotic sensitivity testing done by Kirby - Bauer disc diffusion method.Bacteria was isolated in 201 (28.3%) samples with highest rates among newborns 84(41.8%). The most frequent isolates were 111 (55.2%) followed by 49 (24.4%). Results showed high susceptibilities of CoNS 111 (100%) to Vancomycin, Linezolid and 51 (98%) to Meropenem. This study highlights the common prevalent bacteriological agents in bacteremia, their antibiotic susceptibility & resistance patterns. and multi drug resistant were the leading causes of septicaemia in our hospital with Vancomycin, Linezolid and Carbapenems the effective antibiotics against these pathogens respectively.

Download Full-text

Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal

Tropical Medicine and Health ◽

10.1186/s41182-021-00368-2 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Susil Pyakurel ◽

Mehraj Ansari ◽

Smriti Kattel ◽

Ganesh Rai ◽

Prasha Shrestha ◽

...

Keyword(s):

Bacterial Infections ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Diffusion Method ◽

Clinical Samples ◽

Resistant Bacteria ◽

Growth Media ◽

Care Hospital ◽

Drug Resistant ◽

Biochemical Tests

Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal. Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better understanding of antibiotic resistance threat and enables physicians to select the most appropriate antibiotics.

Download Full-text