Changing Etiology of Urinary Tract Infections and Emergence of Totally Resistant Uropathogens in and around Nanded (Maharashtra) A Seven-Year Study

Abstract

Background: Urinary tract infections (UTIs) remain the most common bacterial infections in developing countries. Knowledge of susceptibility pattern of uropathogens in a specific geographical location is an important factor for choosing suitable antibacterial treatment. Objectives: A study was undertaken to ascertain the spectrum of causative agents responsible for UTIs and to determine the magnitude of drug resistance among them. Results: A total of 1806 organisms were isolated from 3559 urine samples studied during 2010-2016. There is a shift in causative agents of UTI. Escherichia coli have been reappearing and replacing the current pathogen Klebsiella. Coagulase-positive Staphylococci have been significantly replaced by coagulasenegative Staphylococci. Other Gram-negative bacilli belonging to Proteus and Pseudomonas, which were supposed to be major pathogens of UTI particularly in tertiary care hospitals, are surprisingly being less encountered recently. It has been observed that 55.48% of strains were resistant to the antibiotics tested and there was sudden increase in incidence of totally resistant uropathogens during the year 2014. Majority of the totally resistant strains could be seen with Klebsiella (66.23%) followed by Citrobacter (63.28%). Conclusion: These observations indicate extremely high degree of resistance in uropathogens and warrant change in the antibiotic usage as well as formulation of policy for rational use of antibiotics to reduce the emergence of drug resistance in future.