Prevalence and Antimicrobial Susceptibility of Uropathogens Causing Urinary Tract Infections(uti): Study of a Tertiary Care Center in Central India.

Abstract

Objective: To study the prevalence, causative organisms, and antimicrobial sensitivity pattern of Urinary Tract Infection (UTI)at a tertiary care center in Central India. The study was undertaken from September 2021 to May 2022 at t Methods: he Department of Nephrology, SAIMS, Indore. Clean catch midstream urine samples were collected from patients suspected of UTI from patients on OPD basis and inpatients from various departments. The urine samples were processed for Culture and Antibiotic Susceptibility testing after Culture in Mac Conkey/Blood Agar for 24 hours. The interpretation of the bacterial isolates was carried out by VITEK2 automated system. A total of 3241 samples (Females= 1705 Results : and Males=1536) were processed for urine culture and sensitivity. 1022 samples (Females=522, Males=500) were positive for bacterial infection (31.53% positivity rate). Positive isolates were further divided into Outdoor (OPD=315) and Indoor patients (IPD=707) (Wards=480, ICU=227). E. coli was the most common organism in all groups. However, in ICU most common organism was Pseudomonas. Enterococcus was the most common gram-positive organism. ESBL-producing bacteria among Gram-negative bacteria was 67.4%. Carbapenemase-producing bacteria among Gram-negative bacteria were 60.8%. Among Gram-negative oral drugs sensitivity pattern was: Nitrofurantoin (66.1%), Cotrimoxazole (51.65%), Fosfomycin (48.5%), Amoxycillin+Clavulanic acid (41.15%), Ciprooxacin (38.25%), Cexime (20.5%). Pseudomonas was resistant to most oral drugs. Among Intravenous drugs, the sensitivity pattern was: Colistin (89.2%), Amikacin (64.7%), Gentamycin(55.1%), Piperacillin + Tazobactum (44.8%), Tigecycline (43.9%), Meropenam (35.1%), Cefepime (30.1%), Ciprooxacin (24.71%), Cefoperazone+Sulbactum (20.61%). The sensitivity of Klebsiella was lower than E.coli for most of the drugs. Sensitivity for Fluoroquinolones and Cephalosporins is very low. Among Gram-positive oral medications, the sensitivity pattern was: Linezolid (67.8%) and Nitrofurantoin (65.9%). Among Intravenous drug sensitivity pattern was: Teicoplanin (69.27%), Vancomycin (68.5%), Tigecycline (66.15%), and Linezolid(62.05%). The sensitivity of Enterococcus was higher than Staphylococcus for all drugs. The sensitivity of drugs was higher in OPD patients, followed by wards and least in ICU patients indicating multidrug-resistant strains in ICU are more common. Empirical Conclusion: Antibiotics based on regional antibiotic sensitivity patterns should be started and changed as per Culture reports afterwards. It is need of hour to conduct research on the bacteria's culture and sensitivity patterns considering bacterial resistance and multidrug-resistant strains.