Antibiogram of Gram Negative Uropathogens in a Tertiary Care Hospital

2021 ◽  
Vol 8 (2) ◽  
pp. 80-84
Author(s):  
Milind Davane ◽  
Sanjivani Mundhe

Background: Globally, urinary tract infection (UTI) is considered a major public health concern and the second most common bacterial infection affecting individuals of different ages worldwide. Urinary tract infections (UTIs) are caused by multiplicity of microorganisms. The chronicity of different bacterial isolates and their propensity to various antibiotics may differ widely, particularly in hospitalized patients, that makes the study of susceptibility pattern mandatory for a proper selection of antibiotics. Objective: To evaluate antimicrobial susceptibility pattern of the Gram negative organisms isolated from urine cultures of hospitalized patients. Material and Methods: A total of 500 urine samples from hospitalized patients which showed significant bacteriuria were studied. Samples were inoculated on Blood agar and MacConckey agar. Further identification and study of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was studied by Modified Kirby- Bauer’s disc diffusion method with the panel of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) guidelines. Results: UTIs were found more common in females 290 (58%). Commonest organism found was Escherichia coli 260 (52%) followed by Klebsiella spp. 120 (24%), Pseudomonas spp. 40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp. 25 (5%) and Acinetobacter spp. 17 (3.4%). Majority of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactam and cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp. Conclusion: To discourage the indiscriminate use of antibiotics and to prevent further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapy.

Author(s):  
Pradha Velu Ramya Rengaraj ◽  
Hemalatha Gurumurthy Saleem Mohamed Ali

Aims: To determine the prevalence of pathogenic bacteria causing urinary tract infections and their antibiotics susceptibility pattern from patients reporting in a tertiary care teaching hospital. Study design: Retrospective study. Place and duration of the study: Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, January 2017 to December 2019. Methodology: 7825Mid-stream urine (MSU) samples collected for culture and sensitivity testing, sent to the laboratory during the period of study were included in this study. The samples were inoculated onto blood agar and MacConkey agar, incubated at 37°C for 24 hours. Identification of organisms by biochemical tests and antibiotic susceptibility testing were done by standard microbiological methods. Results: Out of 7825 samples, 3832 showed significant bacteriuria, of which 50% (1924/3832) were females. Escherichia coli was the most common pathogen isolated, which accounts for 41% followed by Klebsiella spp. (27%), Staphylococcus aureus (7%), Proteus spp. (7%), Acinetobacter spp. (5%), Pseudomonas spp. (4%), Enterobacter spp. (4%), Citrobacter spp.(4%), and Serratia spp. (0.9%). The antimicrobial susceptibility testing of Staphylococcus aureus showed 33% were Methicillin Resistant Staphylococcus aureus. The antimicrobial susceptibility pattern of gram negative bacilli showed high resistance to cephalosporins followed by carbapenems. Among gram negative bacilli, Klebsiella spp. showed 36% extended spectrum beta lactamases (ESBL) production. Conclusions: This study determines the trends in antimicrobial sensitivity patterns of uropathogens. It is helpful in the formulation of local antibiotic policy for the hospital and assist clinicians in the rational choice of antibiotic therapy to prevent misuse or overuse of antibiotics so as to prevent emergence of multi drug resistant pathogens.


2021 ◽  
Vol 8 (4) ◽  
pp. 268-273
Author(s):  
Pankaj A Joshi ◽  
Ashwini Rajmane ◽  
Vishakha Shikhare ◽  
Meena Ramteerthakar ◽  
Vanita Kulkarni

Urinary tract infection (UTI) is the most commonly acquired bacterial infection. Bacterial biofilms play an important role in urinary tract infections and are responsible for persistent infections as well as higher antimicrobial resistance. The microbial biofilms pose a public health problem as the microorganisms in the biofilms are difficult to treat with antimicrobial agents. So the present study was undertaken with the aim to study biofilm production and antimicrobial susceptibility pattern of urinary isolates. Aerobic bacterial isolates from urine samples submitted to microbiology laboratory for culture were included in the study. The isolates were tested for biofilm formation by Congo red agar method and Christensen tube method. Antimicrobial susceptibility tests were performed on these isolates by Kirby Bauer disk diffusion method as per CLSI guidelines. A total of 293 Gram negative bacilli and 59 Gram positive cocci were tested for biofilm production and antimicrobial susceptibility testing. : Gram‑negative organisms were predominant (83.24%) of all the isolates. Biofilm production was detected in 47% of the isolates. 51.7%), were the most common biofilm producing Gram negative bacilli followed by (44.32%). Amongst Gram positive cocci, (77.8%) was the most common biofilm producing organism. Biofilm producing urinary isolates displayed relatively less percentage of antimicrobial susceptibility than biofilm non producers. Biofilm forming isolates showed higher antimicrobial resistance as compared to biofilm non producer. Early detection of biofilm production in urinary isolates may aid clinicians in treatment of urinary tract infections.


2021 ◽  
pp. 65-67
Author(s):  
Hemendra K Sharma ◽  
Niketa Gupta ◽  
Mahesh Yadav ◽  
Aruna Vyas ◽  
Rajni Sharma

Background: Pyogenic infections can be caused by various microorganisms and may co-exist as poly microbial infections which require antibiotic therapy. The inappropriate use of antibiotics has led to major problems of MDRO's contributing to morbidity and mortality. Even though the bacteriological prole of pus samples in many studies remain the same, antimicrobial susceptibility pattern of these isolates has shown a lot of variation. This study was conducted to assess bacteriological prole of pus samples and their antimicrobial susceptibility pattern Materials and Methods:Aretrospective study was carried out from April to June 2021. 540 pus culture aerobic bacterial isolates were included. The samples were cultured on Blood and MacConkey agar. After aerobic incubation at 37oC for 18-24 hrs, organisms were identied by conventional bacteriology methods as per laboratory protocol and antimicrobial susceptibility was tested by Kirby Bauer disc diffusion method as per CLSI 2020 guideline. Results: Out of 540 pus isolates , 452(83.7%)were gram negative bacili and 88(16.3%) were gram positive cocci Pseudomonas spp. 173(31.9%), was most common gram negative isolate while S.. aureus 66(12.19%) was most common Gram positive isolate. Most of gram negative isolates were susceptible to Imipenem and Polymyxin and gram positive isolates to vancomycin and linezolid . Conclusion: To combat resistance irrational use of antibiotics should be avoided. Also regular surveillance helps in implementing better therapeutic strategies to reduce morbidity and mortality


2020 ◽  
Author(s):  
Adugna Fenta ◽  
Mulat Dagnew ◽  
Setegn Eshetie ◽  
Teshome Belachew

Abstract Background: Urinary tract infection is one of the most common bacterial infections in children. Understanding the characteristics of uropathogens and their antimicrobial susceptibility pattern in a particular setting can provide evidence for the appropriate management of cases. This study aimed to assess the bacterial profile of urinary tract infection, their antimicrobial susceptibility pattern and associated factors among clinically suspected children attending at Felege-Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia.Methods: A hospital-based cross-sectional study was conducted from February-April, 2019. A systematic sampling technique was employed. A mid-stream urine sample was inoculated on cystine lactose electrolyte deficient media and incubated for 24-48 hours. Sub-culturing was done on Mac-Conkey and blood agar. Antimicrobial susceptibility test was done on Muller-Hinton agar. A binary logistic regression model was used to see the association between dependent and independent factors. A p-value<0.05 at 95% CI was considered as statistically significant.Results: The overall prevalence of urinary tract infection was 16.7% (95% CI 12.4-21.1). Both Gram-negative and Gram-positive bacterial isolates were recovered with a rate of 44/50 (88%) and 6/50 (12%) respectively. Among Gram-negative isolates, E. coli 28/44(63.6%) was predominant while S. saprophyticus 2/6(33.3%) was prevalent among Gram-positive bacterial isolates. Overall, a high level of resistance to ampicillin, augmentin, and tetracycline was shown by Gram-negative bacteria with a rate of 44/44(100%), 39/44(88.6%), and36/44 (81.8%) respectively. About 33/50(66%) of overall multidrug resistance was observed (95% CI 52-78). About six Gram-negative bacterial isolates were extended spectrum beta-lactamase (ESBL) producers. Having a history of urinary tract infection (P-0.003, AOR 1.86-22.15) and male uncircumcision (p-0.00, AOR 5.5-65.35) were the independent variables that associate for urinary tract infections.Conclusion: In the present study, the prevalence of urinary tract infection among children was high and considerably a high proportion of multidrug resistance was observed. This result will have a significant impact on the selection of appropriate antimicrobial agents for the treatment of urinary tract infection.


2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Devanand Prakash ◽  
Ramchandra Sahai Saxena

Urinary tract infection is one of the common infections in the Indian community. Distribution and susceptibility of UTI-causing pathogens change according to time and place. This study was conducted to determine the distribution and antimicrobial susceptibility of uropathogens in the Indian community as well as to determine the effect of gender and age on the etiology of bacterial uropathogens. Clean catch midstream urine samples were collected from 288 patients of the age ranging from 15 to ≥48 years. Antimicrobial susceptibility was performed on all isolated bacteria by Kirby Bauer’s disc diffusion method. The multiple antibiotic resistance (MAR) index of each antibiotic was calculated. The UTI prevalence was 53.82% in patients; however, the prevalence was significantly higher in females than in males (females: 73.57%; males: 35.14%; P=0.000). Females within the age group of 26–36 years and elderly males of ≥48 years showed higher prevalence of UTI. Gram negative bacteria (90.32%) were found in high prevalence than Gram positive (9.68%). Escherichia coli (42.58%) was the most prevalent gram negative isolate. Nitrofurantoin (78.71%) was found the most resistant drug among all uropathogens. Tested carbapenems were found the most susceptible drug against isolated uropathogens which showed 92.26% and 84.52% susceptibility, respectively.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Tesfaye Gutema ◽  
Fitsum Weldegebreal ◽  
Dadi Marami ◽  
Zelalem Teklemariam

Urinary tract infection causes considerable morbidity in diabetic patients and if complicated, can cause severe renal damage and life-threatening infections. The escalating antimicrobial resistance rate among bacteria over the past years is another concern in the treatment of urinary tract infections. This study investigated the prevalence, antimicrobial susceptibility pattern of the isolates and associated factors of urinary tract infection among adult diabetic patients attending Metu Karl Heinz Referral Hospital, Southwest Ethiopia. An institutional-based cross-sectional study was conducted among 233 adult diabetic patients selected using simple random sampling technique. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence of pathogenic bacteria and their antimicrobial susceptibility pattern using recommended culture methods. Data were entered, cleaned, and analyzed using the Statistical Program for Social Sciences version 21.0. Statistical significance was set at ap-value < 0.05. The prevalence of urinary tract infection was 16.7% (95%, CI: 12.0, 21.5). The predominant isolates wereEscherichia coli(25.6%) andKlebsiellaspp. (20.5%).E. coliisolates showed higher sensitivity to ceftriaxone (80%), ciprofloxacin (70%), and gentamycin (70%), but resistant to tetracycline (60%).Staphylococcus aureuswas sensitive to amoxicillin-clavulanic acid (85.7%), and gentamycin (57.1%), while resistant to tetracycline (85.7%), nitrofurantoin (85.7%), and ampicillin (71.4%). The odds of developing urinary tract infections were significantly higher in diabetic females (AOR: 3.56, 95% CI: 1.44, 8.76), those who were not able to read and write (AOR: 2.55, 95% CI: 1.19, 5.49) and those with a history of urinary tract infection (AOR: 2.31, 95% CI: 1.09, 4.90) compared with their counterparts. In this study, the prevalence of urinary tract infection among diabetic patients was relatively comparable with the previous studies conducted in Ethiopia. Management of urinary tract infection in diabetic patients should be supported with culture and antimicrobial susceptibility testing.


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