Abstract
Background and objectiveUrinary tract infections (UTIs) are usually treated with empirical therapy by physicians based on previous knowledge of the predictability of causative agents and their antimicrobial susceptibilities. The objective of this study was to determine the frequency of various pathogens causing UTIs and their antimicrobial resistance profile in patients presenting to the outpatient department (OPD) of a tertiary care hospital.Materials and methodsThis descriptive cross-sectional study was conducted in the urology OPD of a tertiary care hospital in Pakistan. The study was conducted over a period of six months, and it included 1,000 patients (of ages 12 years or above) who were clinically suspected for UTIs. Patients with comorbidities and immunocompromised patients were excluded from the study. Recipients of corticosteroid therapy or those with a history of intake of broad-spectrum antibiotics in the previous 15 days were also excluded. The modified Kirby-Bauer disc diffusion method was used for determining antimicrobial resistance against various antimicrobials.ResultsOut of 1,000 tested specimens, 530 (53%) isolates were found to be culture-positive. E.coli was the most common species isolated from the cultures with a prevalence of 77.4%, followed by Klebsiella (6.4%), Enterobacter (6.0%), Pseudomonas (3.8%), Staphylococcus saprophyticus (3.4%), Citrobacter (1.1%), and Morganella (0.4%). Antimicrobial resistance against commonly used antimicrobials was found to be alarmingly high.ConclusionE.coli was the most commonly isolated microorganism from the urine samples of UTI patients. Antimicrobial resistance against UTI-causing organisms is of great concern. The Surveillance of trends of antimicrobial susceptibility pattern for organisms causing UTIs is highly important. Antibiotics should be prescribed according to proper guidelines to prevent increasing antimicrobial resistance.
Highlights
Urinary tract infections (UTIs) are one of the most commonly diagnosed diseases in outpatient departments (OPD) [1]
The selection of antibiotic therapy by a physician to treat UTI is based on the knowledge of prevalent microorganisms, recent updates about the antimicrobial susceptibility patterns, and the clinical status of the patient [2]
A study conducted in Ethiopia showed a varying spectrum of antibiotic sensitivity pattern with 93.3% of the isolates being sensitive to gentamicin; less than 60% of the isolates were sensitive to chloramphenicol, nitrofurantoin, ciprofloxacin, trimethoprim-sulfamethoxazole (TMP-SMX), ceftriaxone, and nalidixic acid [5]
Summary
Urinary tract infections (UTIs) are one of the most commonly diagnosed diseases in outpatient departments (OPD) [1]. The selection of antibiotic therapy by a physician to treat UTI is based on the knowledge of prevalent microorganisms, recent updates about the antimicrobial susceptibility patterns, and the clinical status of the patient [2]. Studies have shown that E.coli is the most commonly isolated microorganism from UTI patients with a varying prevalence ranging from 26 to 55% [3,4]. Urinary tract infections (UTIs) are usually treated with empirical therapy by physicians based on previous knowledge of the predictability of causative agents and their antimicrobial susceptibilities. The objective of this study was to determine the frequency of various pathogens causing UTIs and their antimicrobial resistance profile in patients presenting to the outpatient department (OPD) of a tertiary care hospital
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