Urinary Tract Infection among Inpatients: An Insight into Risk Factors and Antimicrobial Resistance

Abstract

Background: Gram negative organisms are the leading cause of Urinary tract infections with increasingly prevalent antimicrobial resistance. Thereby an observational cross sectional study was conducted to determine the rate of isolation, evaluation of the risk factors and antimicrobial resistance pattern of these organisms. Methods: In the prospective analysis, 72 urine samples with significant bacteriuria and culture positive for gram negative bacteria confirmed biochemically, among inpatients were taken into consideration. In addition presence of risk factors was evaluated. Antibiotic susceptibility test was performed using Kirby Bauer's disk diffusion method. Results: E. coli accounted for 56.9% followed by Klebsiella species (23.6%). Enterobacter, Pseudomonas and Acinetobacter species were 5-8% prevalent. The risk factors like diabetes mellitus and pregnancy were 20.8% and 13.8%. Other risk factors like recurrent UTI, renal stones, presence of indwelling catheter, smoking, use of OCP/IUCD and post menopausal oestrogen deficiency were 1-7%. The antimicrobial resistance for Enterobacteriaceae group of organisms were 70-90% for cefuroxime, ceftriaxone, cefepime and co-trimoxazole, 50-53% for ciprofloxacin and norfloxacin, 32.2% for ampicillin-sulbactum, 19.3% for nitrofurantoin, 8.1% for amikacin, 20.9% for piperacillin-tazobactum and 14.5% for imipenem. The antimicrobial resistance for Pseudomonas and Acinetobacter species was 50% for ceftazidime and cepepime, 20% for amikacin, piperacillin-tazobactum and imipenem, and 0% for meropenem. Conclusion: The present study confers Escherichia coli as the predominant bacterial isolate and diabetes mellitus as the predominant risk factor causing UTI. Amikacin, piperacillin-tazobactum and imipenem are the most sensitive drugs.