Microbiological Profile and Antibiotic Sensitivity Pattern In Community Acquired Urinary Tract Infection: Study From A Tertiary Care Hospital

Abstract

Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empiric therapy while managing UTIs. Objectives: The aim and objective of this study was to detect the common organisms causing community acquired UTI in our region which is a part of Eastern India and their sensitivity and resistance pattern towards different commonly used antimicrobial agents. Material and methods: The present study is a prospective observational study carried out in a tertiary care teaching hospital in Odisha, India for a period of one year. Only hospitalized patients were included in the study after exercising the inclusion and exclusion criteria. A total of 240 samples were tested for bacteriological and antibiotic sensitivity study using standard procedures. Results: Out of 240 urine samples, 124 samples tested positive for culture .The most common isolate was E. coli accounting for 40% of the total isolates. Klebsiella pneumoniae(24%), Enterococcus Species (16%), Pseudomonas aeruginosa (6%) and Staph. aureus (6%) were the other common isolates. E. coli which was responsible for highest number of cases was found to be sensitive to colistin (94%), Amikacin(84%) ,Nitrofurantoin (80%) and Imipenem (72%) but was resistant to antimicrobials like Ampicillin(88%), Amoxicillin(72%), Cefuroxime(88%) and Ciprofloxacin(88%). Conclusion: Our study showed that common organisms causing Community acquired UTI are resistant to antimicrobials frequently prescribed by clinicians like Ampicillin, Amoxicillin,Cefuroxime, Ciprofloxacin and Levofloxacin and should be avoided .Nitrofurantoin and Amikacin are still effective against a good number of uropathogens and can be considered for empiric therapy. Broad spectrum antibiotics like Colistin, Imipenem, Tigecycline, Teicoplanin, Pip-Taz and Linezolid have shown effectiveness but should be judiciously used in appropriate situation and at proper dosage to avoid development of resistance.