Antimicrobial resistance trends in bacterial isolates from urinary tract infections at a medical college in Eastern India - A retrospective observational study

Abstract

Background: Urinary tract infection (UTI) is the most common cause of morbidity in both community and hospital. Female gender, old age, bad genital hygiene, and diabetes are the most common risk factors for UTIs. In most cases in resource poor area, clinician treats UTI patient with empirical antibiotics. Still, there is always a paucity of data about the microbial profile and antibiogram of common uropathogens that are variable in different areas. Aims and Objectives: This study was conducted to guide clinicians with microbial profiles and antibiogram of uropathogens isolated in a medical college in the western part of West Bengal to select appropriate empirical antibiotics for the treatment of UTI. Materials and Methods: It was an observational descriptive study conducted on urine samples received in the tertiary care center of Eastern India from suspected UTI patients. Microbial profile and antibiogram of common uropathogens were formulated and data were analyzed on Microsoft Excel sheet. Results: 35.07% (195/556) sample showed significant bacteriuria. Females (40.87%) were affected more as compared to males (28.46%). The highest prevalence was seen in males in the age group >60 years and in the case of females, it was 31–40 years. The most common bacteria isolated was Escherichia coli (32.9%) followed by Enterococcus species (24.7%). The most sensitive antibiotic was colistin but the most useful antibiotics were carbapenem, aminoglycoside, fosfomycin, and nitrofurantoin. Fluoroquinolones, the previous drug of choice for uncomplicated UTI, showed a high resistance rate. Conclusion: As empirical therapy in uncomplicated UTI, clinicians should use fosfomycin or nitrofurantoin as a drug of choice in place of fluoroquinolones or cotrimoxazole and in complicated UTI, the drug of choice should be either aminoglycoside or carbapenem depending on renal functionality of the patient.