Antimicrobial Susceptibility Pattern of Urinary Pathogens in a Tertiary Care Hospital

Abstract

BACKGROUND Urinary tract Infection (UTI) are the most common clinical conditions in general practice and gynaecological department. Men and women of all age groups are affected by UTI, but its overall prevalence is higher in women. The major causative agents are Escherichia coli and other Enterobacteriaceae. In majority of the cases, empirically treatment is started with antimicrobials before the urine culture and sensitivity reports become available. This has led to an increase in antibiotic resistance in urinary pathogens. Hence, the present study was undertaken to determine the antimicrobial susceptibility pattern of uropathogens to commonly used antimicrobials in treating UTIs. METHODS A total of 200 urine samples were obtained from patients with signs and symptoms suggestive of UTIs attending Bapuji and Chigateri General Hospital which are attached to Jagadguru Jayadeva Murugarajendra Medical College (JJMMC), Davangere for a period of 3 months that is from May 2016 to July 2016. Urine samples were processed within 2 hours of reaching the laboratory. Semi quantitative urine culture was done. Isolation and identification were done by performing standard biochemical tests and the antimicrobial susceptibility testing was done using the standard disc diffusion method by Kirby-Bauer technique. RESULTS There were 170 urinary isolates from 200 samples. Children less than 10 years were more affected 54 (27 %). Female patients were more, 119 (59.5 %) compared to males 81 (40.5 %). Escherichia coli was the most predominant isolate, 71 (41.8 %) followed by Enterococcus species 22 (1.9 %). Organisms were resistant to commonly used antibiotics i.e., cotrimoxazole, ciprofloxacin, norfloxacin and amoxicillin. Both gram negative and gram-positive isolates were sensitive to amikacin and nitrofurantoin. CONCLUSIONS In present study Escherichia coli is the predominant pathogen. Uncomplicated UTIs can be empirically treated by nitrofurantoin. Occurrence of treatment failure with commonly used antimicrobials is more often in Indian setting. Hence, antimicrobial susceptibility testing must be employed routinely. KEY WORDS UTIs, Uropathogens, E. coli, Antimicrobial Susceptibility Pattern