Prevalence and Phenotypic Profile of Antimicrobial Resistance Pattern of Multidrug Resistant Uropathogens in a Rural Tertiary Care Hospital, Gujarat, India

Abstract

Introduction: Multidrug Resistant (MDR) organisms have become a major problem for the treatment of various infections and are imposing the greatest challenge to public health worldwide. Uncomplicated Urinary Tract Infections (UTIs) are treated empirically sometimes with broad spectrum antibiotics without performing drug susceptibility tests that adds to drug resistance in bacteria. Aim: To identify the current prevalence and evaluate phenotypic profile of antimicrobial resistance pattern of MDR uropathogens. Materials and Methods: This was a cross-sectional descriptive study conducted from January 2019 to July 2021 at Parul Sevashram Hospital Vadodara, Gujarat, India. Total 960 uropathogens were analysed for prevalence, their phenotypic antimicrobial resistance mechanism and antibiotic sensitivity pattern. Isolated organisms, their phenotypic resistance pattern and antibiotic sensitivity data was entered in Microsoft excel and data were analysed using Statistical Package for the Social Sciences (SPSS) 25.0 version. Results: During the study period, total 960 urinary isolates were analysed of which 891 (92.8%) were gram negative bacilli, 69 (7.2%) were gram positive cocci. Probable antimicrobial resistance pattern in gram negative isolates causing UTI were 317 (35.6%) of Extended Spectrum Beta Lactamase (ESBL) producer, While carbapenemase (+ or - ESBL) were 328 (36.8%) and impermeability carba (+ESBL or +High-Level Ampicillinase C (HL AmpC)) were 311 (34.9%). Amikacin was highly sensitive antibiotic in 378 (75.3%) of Escherichia coli (E. coli) and 111 (52.9%) of Klebsiella pneumoniae (K. pneumoniae) isolates causing UTI. Conclusion: The study concluded that carbapenem resistance was more in K. pneumoniae isolates causing UTI than E. coli. Aminoglycosides like amikacin was highly effective for the treatment of UTI caused by E.coli and K. pneumoniae.