Bacteriological profile of urinary tract infections at a tertiary care hospital in Western Uttar Pradesh, India

Abstract

Background: This prospective study was intended to identify the bacterial pathogens causing urinary tract infections and their antimicrobial resistance patterns in a tertiary care teaching hospital of Western Uttar Pradesh, India.Methods: Clean-catch mid-stream urine samples were collected from patients symptomatic for UTI. Samples were cultured aerobically on CLED agar and strains having significant growth (>105cfu/ml) were further processed for identification using standard microbiological techniques and their antimicrobial susceptibility pattern evaluated by Kirby Bauer disk diffusion as per CLSI guidelines.Results: Out of the 2250 urine samples processed, 750 showed significant growth on aerobic culture. Thus, the prevalence of UTI in the population was 33.3%. E. coli was the commonest isolate (33.3%) followed by S. aureus (20 %), Klebsiella spp. (13.3%), Coagulase Negative Staphylococci (13.3%), Enterococcus spp. (6.7%), Pseudomonas spp. (6.7%) and Candida spp. (6.7%). Amongst these isolates, Gram negative bacilli have shown a high susceptibility to imipenem, levofloxacin, nitrofurantoin, linezolid and amoxyclav and Gram positive organisms towards levofloxacin, nitrofurantoin, linezolid, vancomycin and amikacin.Conclusions: This study has shown nitrofurantoin and fluoroquinolones to be the most effective drugs for the empirical therapy of UTI in our region. The study of antimicrobial susceptibility pattern of UTI in a particular area can guide the clinicians in the rational choice of antibiotic treatment so that misuse of antibiotics can be prevented.

Prevalence and antibiotic susceptibility patterns of pseudomonas aeruginosa in urinary tract infections in a Tertiary care hospital, Central Kerala: A retrospective study over 4 years

“…In the present study P.aeruginosa was the third most common urinary isolate after E,coli and Klebsiella species Otherauthors also observed P.aeruginosa asthe third most frequent urinary isolate [10][11][12][13]. In some studies it acquiredsecond positionbut in a recent study from Pakisthan it rankedonly fifth [2,4]. The isolation rates in the present study is compared to some recent studies from India and other countries (Table:4).…”

“…25% of the isolates are Pipereacillin -tazobactam resistant. Similar pattern of resistance to Piperacillin-tazobactamwas observed by various authors butan extremely high resistance was noticed by a study conducted by Sangeeta et al [2,10,13,4,16,17]. Penicillins are highly ineffective against P aeruginosa except for Piperacillin-tazobactam because of the beta lactamase inhibitor in addition to the extended spectrum and scare use of the drug [4].…”

“…Among Fluoroquinolones, Ciprofloxacin, Norfloxacin and Ofloxacin showed almost similar resistance of 43.7%, 40.6% and 40.6% respectively. Different authors observed the resistance of ciprofloxacin as low as zero to as high as 90% [2,4,10,11,15,16,19]. Principal modes of Flouroquinolone resistance in P. aeruginosa is due totarget modifications in DNA gyrase (gyr A) andtopoisomerase IV(par C) or mutations in regulatory genesfor efflux pumps that reduce intracellular concentrationsof the antibiotic [20].…”

“…Urinary tract infections (UTI) are the most common infections encountered by clinicians and one of the leading causes of morbidity in human population [1,2]. Although Escherichia coli.…”

Comparative evaluation of different culture media for the isolation and identification of common urinary pathogens

“…Escherichia coli are the most commonly isolated organism. Findings are in comparison to the studies done by Singh VP and Gupta V. 13,14 In this study, isolation rate of gram negative bacilli from three different media i.e. CLED agar, MacConkey agar and blood agar was same, all 126 gram negative bacilli were grown on three media.…”