Antimicrobial resistance in pathogens causing urinary tract infections in a rural community of Odisha, India (original) (raw)
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URINARY TRACT INFECTION: BACTERIOLOGICAL PROFILE AND ITS ANTIBIOTIC SUSCEPTIBILITY IN WESTERN INDIA
National Journal of Medical Research, 2015
Introduction: Urinary tract infections (UTIs) are counted among the most common infections in humans. In spite of the availability and use of the antimicrobial drugs, UTIs caused by bacteria have been showing increasing trends. The extensive and inappropriate use of antimicrobial agents has invariably resulted in the development of antibiotic resistance which, in recent years, has become a major problem worldwide. Materials & Methods: Patients diagnosed clinically as UTI during the study period were included in the study. Urine sample of these patients were tested for Culture. All positive cultures were tested for antibiotic susceptibility. Results: Out of total 232 patients, Isolates were detected in 177 (76.29%) samples. Out of these, 137 (77.40%) were female. Most common organism found positive was Escherichia Coli. E. coli was highly sensitive to Amikacin and Nitrofurantoin. Whereas, E.coli was highly resistant to Ampicillin and Nalidixic acid. Antibiotic sensitivity pattern of Klebsiella and Acinitobacter shows that they were also highly sensitive to Amikacin. Klebsiella and Acinobacter were highly resistant to Ampicillin and Gentamycin. Conclusion: The pattern of resistance to commonly used antibiotics for treating UTI alerts us against indiscriminate usage of antibiotics
Community-acquired Urinary Tract Infection (CA-UTI) is a very common condition and often treated by empirical antibiotic therapy. This has led to the problem of drug resistance in the community pathogens. As information on profile and antibiotic resistance, especially from rural areas is very hard to come by, this study was carried out on adult CA-UTI subjects presenting in a rural tertiary care teaching hospital of lower Assam. Outdoor patients were included and urine samples were tested by standard microbiological methods. Isolated organisms were processed for antibiotic susceptibility and MIC (selected cases). Out of 1436 samples 27.1% was found to have significant bacteriuria by single agents with more infection in female than in male. E coli was the predominant agent (62.2%) followed by Coagulase Negative Staphylococcus (CONS) at 11.8%, Klebsiella (11.3%) and Entercocci (6.3%). High prevalence of drug resistance amongst the isolates was observed, especially against common agent of empirical treatments like Ciprofloxacin, Amoxycalv etc. MIC level of Ciprofloxacin in E coli seemed to be rising and in few cases, level has reached beyond 32mcg/ml. This is alarming for a community pathogen from a rural area. Urgent necessity for an evidence based antibiotic policy cannot be ruled out.
2021
Introduction: Urinary tract infections (UTI) are one of the most common infectious diseases diagnosed.UTI account for a large proportion of antibacterial drug consumption and have large socioeconomic impacts. Since the majority of the treatments begins or is done completely empirically, the knowledge of the organisms, their epidemiological characteristics and their antibacterial susceptibility that may vary with time is mandatory. Objectives: The aim of this study was to report the prevalence of uropathogens and their antibiotic susceptibility of the community acquired UTI diagnosed in a multi speciality hospital Coimbatore. Methodology:We analyzed retrospectively the results of urine cultures of 150 patients had community acquired urinary tract infection in the year of 2019-2020. Patient were included in the study as per inclusion and exclusion criteria. At the time of enrollment subjects data like age, gender, co-morbid condition (DM, HTN, DYSLIPIDEMIA),organism , culture and sensitivity, and treatment were assessed by using designed data collection form with culture and sensitivity form. Results: The mean age of the patients in this study was 57.51 ± 18.96(SD) years. There were 85(56.67%) females and 65 (43.33%) males. The most commonly isolated organism was Escherichia coli (80.67%), klebsiella pneumoniae (15.33%), pseudomonas aeruginosa (3.33%) and salmonella enterica (0.67%)were reported as the next most common organisms. Of the 121 isolates of Escherichia coli (n=112) 92.56% resistance were found in Ampicillin, Nalidixic acid (n=99) 81.82%each. The 23 isolates of klebsiella pneumoniae (n=22) 95.65% resistance were found in Ampicillin, followed by Cefuroxime, Cefuroxime axetil (n=19) 82.61%each.The most commonly prescribed antibiotics during the entire study period were Nitrofurantoin which was accounted by (n=53) 35.33% prescriptions, followed by piperacillin /Tazobactam (n=51) 34%, Cefoperazone/sulbactam (n=30) 20% and Doxycycline (n=28) 18.67% etc. The antimicrobial resistance rates among E. coli isolates for Ciprofloxacin and Nitrofurantoin were 75.21%, 0.83% respectively (P < 0.05). Conclusion: The results of the study indicate that nitrofurantoin and Piperacillin/Tazobactam may be considered for empirical therapy of CA-UTIs in Coimbatore region, Tamil Nadu.
Antibiotic resistance pattern of Uropathogens in a tertiary care hospital of Central India
IP Innovative Publication Pvt. Ltd, 2017
Background: Urinary tract infection is one of the most common bacterial infections in human being. The causative agent of UTI varies from place to place and they also vary in their resistance pattern. Objective: This study was conducted to know the most common causative agents, determine distribution and resistance pattern of bacterial strains isolated from patients with UTI from a tertiary care hospital of Central India. Materials and Method: Urinary isolates from symptomatic UTI patents were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby Bauer's disk diffusion method. Results: Of the 1800 tested samples, 696 samples showed growth of organisms among which the most prevalent were E.coli (60%), followed by Klebsiella species (10.4%).The majority of isolates were from female patients of reproductive age group. E.coli and Klebsiella spp. showed high resistance to Ampicillin, Third generation cephalosporin (3GC) and Norfloxacin and best sensitivity for Imipenem and Nitrofurantoin. Among gram positive bacteria high resistance was observed against Penicillin and Ampicillin and all isolates were sensitive to Vancomycin. Conclusion: This study revealed that UTI is more common in females particularly in reproductive age group. E.coli was the predominant bacterial pathogen. Urinary pathogens showed resistance to commonly used antibiotics like Ampicillin, 3GC and Norfloxacin. As good sensitivity was seen for Nitrofurantoin in all organisms, it can be used for empirical treatment against UTI.
Introduction Urinary tract infections (UTI) are common infections encountered by physicians either on an outpatient or inpatient basis. These infections have taken center stage due to increasing resistance being reported for commonly used antibiotics. Understanding the distribution and antibiotic susceptibility patterns of uropathogens would facilitate appropriate therapy. Methods A retrospective analysis of the culture isolates obtained from urine samples received at the Results Of the 5592 urine specimens received, 28.2% showed significant growth. A total of 1673 identified pathogens were used in the analysis. Escherichia coli (54.6%) was the most common Gram-negative bacillus, followed by Klebsiella species (9.7%) and Pseudomonas species (7.5%). The most common Gram-positive coccus was Enterococcus (8.8%). Most of the Gram-negative isolates were resistant to ampicillin (79.3%) and cephalosporins (60%). Resistance to cephalosporins and fluoroquinolones was higher in isolates from inpatients. Other than Klebsiella spp., all other Enterobacteriaceae were susceptible to carbapenems (93%) and aminoglycosides (85%), whilst fluoroquinolones were effective for all Gram-positive bacteria. Conclusion Due to a high level of antimicrobial resistance amongst the pathogens causing UTI in India, it is cautious to advise or modify therapy, as far as possible, after culture and sensitivity testing have been performed. Regional surveillance programs are warranted for the development of national UTI guidelines.
Indian Journal of Microbiology Research, 2020
Background and Objective: Urinary tract infections (UTI) are amongst the most common bacterial infections in developing countries. The etiology of UTI and the antibiotic resistance of uropathogenes vary in regions and change through times. Regular surveillance of the changing trends in its bacteriological profile and antibiotic sensitivity pattern is therefore mandatory. This study aims to find out the changing trends in the prevalence and antibiotic susceptibility patterns of urinary isolates of over five consecutive years. Materials and Methods: A retrospective, record based study was conducted on all culture and sensitivity (C/S) reports of urine samples obtained in the microbiology laboratory in a tertiary care centre, Central Kerala (January 2012-December 2016). The C/S reports which were positive for significant growth were analyzed to find out its prevalence and antibiotic susceptibility patterns. Descriptive statistics was used for data analysis and the results were expressed in percentages. Result: Of the 14105, urine specimens received, 27.93% were positive. Highest rate of UTI is seen in female patients (67.58%) and geriatric age group 47.58%. E.coli and Klebsiella are the two most common isolates from all five years of study period and constituted~72% of total. The year wise analysis of antibiotic resistance showed fluctuating pattern. The resistance rate to drugs like Piperacillin-tazobactam and carbepenem showed increasing drug resistance. E.coli was found to be more sensitive to Amikacin and nitrofurantoin. Conclusion: Drug resistant strains are markedly high in our area. Antibiotic resistance does not show a consistent trend over years and vary from region to region. Therefore each institution should have an antibiotic policy based on the local antibiogram which is to be renewed regularly.
Objectives: To characterize the pattern of indication of antibiotic regimens for CA-UTI; to evaluate the adequacy of antibiotic empirical therapy in CA-UTI and the resistance profile of the bacterial isolates. Methods: An observational study was conducted, where the prevalence and resistance profiles of the microorganisms involved and the pattern of antibiotic indication were investigated through a cross-sectional approach. Patients presenting with UTI symptomatology and antibiotic indication were recruited through pharmacies in the Lisbon area. Upon inclusion, participants collected a urine sample and responded to a questionnaire characterizing the indication pattern and symptomatology presented. Samples were referred to a microbiology laboratory for urinalysis and antimicrobial susceptibility tests were performed according to EUCAST. Data were analyzed using IBM SPSS v20.0. Results: A sample of 33 patients was obtained. Given the indicated therapy, 55.2% (n=6) corresponded to first line therapy and 10.3% to fluoroquinolones. It was also found that 6 (22.2%) patients were treated with antibiotics and had no confirmed UTI. The most isolated microorganism was E. coli (84.2%), followed by P. mirabilis (5.3%), P. aeruginosa (5.3%) and Klebsiella sp. (5.3%). Finally, a low resistance to first-line therapy and quinolones was observed, whilst high resistance was found to amoxicillin clavulanate (n=10; 52.6%). Conclusion: This study revealed that most patients with UTI used nitrofurantoin and fosfomycin empirically (both included in first line therapy), and only a small number used quinolones. As expected, the most commonly isolated microorganism was E. coli. A worrisome finding was that nearly a quarter of patients were prescribed antibiotics without indication.
Journal of Family Medicine and Primary Care, 2015
Introduction: Uncomplicated but symptomatic urinary tract infections (UTIs) are a common problem seen in practice. The study was undertaken to assess the most common pathogens responsible for uncomplicated symptomatic UTIs and the antimicrobial resistance pattern in a hospital in Bangalore. The study also explores the issue of antibiotic usage for these patients. Materials and Methods: The study was conducted in the Medicine department of a tertiary hospital in Bangalore. In all, 196 patients presented with symptoms of UTI. Bacterial growth was determined by standard microbiology techniques on freshly voided mid-steam urine samples collected from recruited patients. Patients' demographic data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results: The prevalence of UTI was 32.1%; majority (67.9%) of the symptomatic did not have UTI based on culture report. Gram-negative bacteria constituted the largest group with a prevalence of 84.1% (53/63), with Escherichia coli being the most common (70%) uropathogen. Gram-negative isolates showed high level of sensitivity to amikacin (90.6%) and nitrofurantoin (77.4%). Most of the gram-positive organisms were susceptible to nitrofurantoin (70%) and gentamicin (50%). Uropathogens isolated demonstrated high resistance to cotrimoxazole, fluoroquinolones, and beta-lactam antibiotics. It was found out that 30.1% of the patients were wrongly managed of which 14.7% were over treated. Conclusion: UTI can be over diagnosed and over treated on the basis of clinical signs, symptoms and urine microscopy. In the era of emerging anti-microbial resistance, effective counseling and delay in antibiotic initiation or empirical therapy with a short course of nitrofurantoin is highly recommended. Empirical therapy guidelines should be updated periodically to reflect changes in antimicrobial resistance of uropathogens.
International Journal of Enteric Pathogens, 2015
Background: Urinary tract infections (UTIs) are one of the most common bacterial diseases. The etiological agents and emergence of antimicrobial resistance UTIs vary according to time and geographical region. Objectives: The present study aimed to determine the prevalence of etiological agents of UTIs and determine their antimicrobial susceptibility pattern to locally available antibiotics. Patients and Methods: This descriptive cross-sectional study was conducted within six months on all patients with clinical symptoms of UTI who referred to Nemazee Teaching hospital, Shiraz, Iran. Clean catch midstream urine samples were collected and cultured on appropriate media in a short time as possible. Conventional bacteriological methods were followed for the isolation and identification of the bacteria. Antimicrobial susceptibility profiles were determined by locally available antibiotics by using disk diffusion method in accordance with CLSI recommendation. Results: In this study, from overall 9991 specimens analyzed 848 (8.5%) culture had significant bacterial growth. Of the total positive cultures, 500 (59%) cases were female. Escherichia coli (50.6%) was the predominant gram-negative isolated pathogen followed by Klebsiella spp. and Enterobacter spp., respectively. Enterococcus isolates (11.2%) was the most isolated gram-positive cocci. Nitrofurantoin (80.9%), gentamycin (77.9%) and amikacin (65.3%) had the most in-vitro antibacterial effect on E. coli isolates as the predominant cause of UTIs. Conclusions: The results of regional assessments, such as our study, provide not only useful information for prescription of more effective empirical therapy, but also good epidemiological background for comparison of our situation with other regions.