Pattern of Antimicrobial Resistance to <i>Escherichia Coli</i> Among the Urinary Tract Infection Patients in Bangladesh

Abstract

Urinary Tract Infection (UTI) is very common in our day-today clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.

Prevalence, antibiotic resistance pattern for bacteriuria from patients with urinary tract infections

“…Urinary tract infection (UTI) is the second most common infection, affecting 150 million people, both males and females, annually worldwide 1‐5 . However, females are more susceptible to UTIs than males because their urethra is typically shorter and more conveniently located near the rectum, which makes them vulnerable to uropathogenic bacteria and causes infection 3,6‐12 .…”

Prevalence, etiology and antibiotic resistance patterns of community-acquired urinary tract infections in Dhaka, Bangladesh

“…A recent study has shown that more than 75% of E . coli causing UTI are resistant to third-generation cephalosporin [ 16 ]. Existing reports are based on either a small sample size, targeting only a specific population or age group, analysis of retrospective data from hospital registry, or characterization of convenience samples of bacterial isolates obtained from urine samples of UTI patients [ 17 , 18 ].…”

“…A study carried out in 2012 among 443 suspected UTI patients in a regional medical college hospital in Bangladesh showed that 43% of patients had significant bacterial growth of uropathogens in their urine samples [15]. A recent study has shown that more than 75% of E. coli causing UTI are resistant to third-generation cephalosporin [16]. Existing reports are based on either a small sample size, targeting only a specific population or age group, analysis of retrospective data from hospital registry, or characterization of convenience samples of bacterial isolates obtained from urine samples of UTI patients [17,18].…”

Antimicrobial Susceptibility Pattern of Uropathogens Isolated at a Private Hospital in Khulna, Bangladesh

“…12 An alarming picture has been reflected by a recent study in Bangladesh, which demonstrated more than 75% of the E. coli causing UTIs are resistant to third-generation cephalosporins. 13 In Bangladesh UTI is a significant public health problem & increasing antibiotic resistance even complicates the treatment of uncomplicated UTI by increasing patient morbidity & health care costs due to frequent treatment failure, recurrent infections & unnecessary use of broad-spectrum antimicrobials. 10,14 There is no large-scale prospective survey of UTIs in Bangladesh, that can reflect the up-to-date burden of the infections & the antimicrobial susceptibility pattern in the community.…”