Analysis of WHONET Surveillance Data of Antimicrobial Sensitivity of Uropathogens in a Tertiary Care Hospital: An Indicator to Empirical Antimicrobial Treatment for Urinary Tract Infection

Abstract

Introduction: Urinary Tract Infections (UTIs) are among the most common bacterial infections. A regular surveillance of local aetiology and susceptibility profile could support the most effective empirical treatment. WHONET (World Health Organisation Network) is free software developed since 1989 by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance. Aim: Analysis of WHONET surveillance data was undertaken to know the aetiological profile of uropathogens and their antimicrobial susceptibility pattern to formulate an empirical treatment policy in a tertiary care hospital. Materials and Methods: The present study was retrospective and cross-sectional study. Uropathogens and their antimicrobial susceptibility from a tertiary care hospital during July 2018 to June 2019 were studied. For analysis, the software WHONET 5.6 version was used. An inclusion criterion was uropathogens with significant growth of one pathogen and only the first isolate of a given species encountered in case there were repeat samples from the same patient. Chi-square test was used to compare percentages and p-value <0.05 was considered as statistically significant. Results:Of the 1152 non-duplicate uropathogens, Enterobacteriaceae was the causative agent in 75% cases, E. coli accounting for more than two third of the cases. Gram positive cocci and Non-fermenters were isolated in 13% and 10% cases respectively. S. aureus, E. faecalis and Enterobacteriaceae showed high sensitivity to nitrofurantoin. Conclusion: For uropathogens, nitrofurantoin can be the drug of choice for empirical treatment of UTI. However, in serious hospitalised patients with UTI, additional parenteral administration of piperacillin-tazobactam may be considered.