Antimicrobial susceptibility pattern of urine culture isolates in a tertiary care hospital of Jharkhand, India

Abstract

Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So, regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empirical therapy while managing UTIs. The purpose of the study was to identify different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in outpatient and indoor patients at RIMS, Ranchi, Jharkhand.Methods: Observational study was conducted using urine culture and sensitivity reports collected retrospectively from records maintained in the department of Microbiology over a period from July 2016 to Feb 2017 in tertiary care hospital.Results: UTI was more common in females (57.74%) than in males (42.26%). Among the uropathogens isolated Escherichia coli (37.41%) was found to be the predominant organism followed by Klebsiella species (32.79%), Pseudomonas species (25.86%), and gram-positive bacteria Staphylococcus aureus accounted (3.92%) of total cases. The most common isolates were E. coli showed high sensitivity to amikacin (79.24%), followed by levofloxacin (77.21%) and gentamycin (62.26%). It was found to be resistant to norfloxacin (86%), nalidixic acid (86.76%) and cefotaxime (69.88%).Conclusions: Though various microorganisms are responsible for UTI. Escherichia coli species is the most common organism. Antimicrobial resistance has already emerged against many antibiotics, making empirical treatment of these infections challenging.

Antibiotic Resistance Pattern of Urinary Isolates in a Tertiary Care Hospital in Berhampore, West Bengal

“…They were highly resistant to aminoglycosides, macrolides and fluoroquinolones as also reported by Hasan AS et al 22 Vancomycin resistance was reported in 14.5% of isolates as compared to 1.82% reported by Sood S et al 20 5.1% of Staphylococcus aureus exhibited resistance to linezolid compared to the 9.1% reported by Hasan AS et al 22 Vancomycin resistance was shown by 43.6% of Staphylococcus aureus isolates similar to the study by Kumar A et al (43.87%). 21 In our study, imipenem resistance was reported in 28.2% of Enterococcus spp. and 2.6% of Staphylococcus aureus in contrast to 8.2% and 14% reported by Somashekara SC et al respectively.…”

“…This was similar to the findings by Sood S et al, who reported UTI from 37.67% males and 62.42% females. 20 Female preponderance was reported from various studies: 57.74% by Kumar A et al, 70.5% by Hasan AS et al and 39.9% females compared to 9.1% males by Semwal AC et al 21,22,23 However, Patil S et al reported a slight male preponderance (57%). 24 The female preponderance is probably related to the short length of the female urethra and its proximity to the anal opening facilitating entry of bacteria into the urinary tract easily.…”

“…Imipenem was also reported as the least resistant antibiotic by Kumar A et al (0-1.76%), Somashekara SC et al (14.7%) and Manjunath GN et al (7.5%). 21,28,30 The organisms were highly sensitive to meropenem, piperacillin/tazobactam and nitrofurantoin except for the Klebsiella spp., which showed an unusually high resistance to meropenem (68.8%) for unknown reasons. This is in concordance with studies by Kumar A et al and Semwal AC et al 21,23 Similar low resistance to nitrofurantoin was reported by Sood S et al and Patil S et al (15%).…”

“…21,28,30 The organisms were highly sensitive to meropenem, piperacillin/tazobactam and nitrofurantoin except for the Klebsiella spp., which showed an unusually high resistance to meropenem (68.8%) for unknown reasons. This is in concordance with studies by Kumar A et al and Semwal AC et al 21,23 Similar low resistance to nitrofurantoin was reported by Sood S et al and Patil S et al (15%). 20,24 This may be related to the low usage of Imipenem, meropenem and piperacillin/ tazobactam in the community.…”

Antibiotic Resistance Pattern of Uropathogens in a Tertiary Care Hospital in Calabar, Nigeria

“…Urinary tract infections (UTI) are defined by the presence of a growth of more than 10 5 colony forming units (CFU) of bacteria per ml of urine for asymptomatic individual and ~10 3 CFU/ml for symptomatic individual [1,2]. In urine samples obtained by supra pubic aspiration or catheterization and in samples from a patient with an indwelling catheter, colony count of 10 2 -10 4 CFU/ml generally signifies urinary tract infection [1]. UTI are one of the commonest clinical conditions encountered by physicians and accounts for 1-6% of all medical visits [3].…”