Abstract

Background: The resistance pattern of uropathogens is increasing very rapidly because of the unsorted, insufficient, and incoherent usage of antibiotics. The aim of this study was to evaluate the prevalence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) uropathogens which were isolated from the urinary tract infection (UTI) cases in Dhaka, Bangladesh. Methods: In this cross-sectional study, a total of 21167 urine samples were collected from January 2016 to December 2018, followed by using conventional methods, as well as Kirby-Bauer disc diffusion method for urine culture and susceptibility, respectively. Finally, SPSS software was utilized to analyze the obtained data. Results: From among 21167 urine samples, 2469 (11.66%) cases were bacteriologically positive. In UTI cases, males proportion were higher compared to females (in ≤ 10 and > 60 to ≤90 years age groups) and females in the age groups between 10 and 60 and >90 years suffered more than males (P<0.05). In addition, 172 (7.0%), 1337 (54.2%), and 845 (34.2%) cases were identified as XDR, single drug-resistance (SDR), and nondrug-resistance (NDR), respectively. Although the number of female XDR cases was higher than males, the percentages of male cases were higher compared to female cases in this study. The most predominant drugresistance cases (18.7%) were found in the age group between 21 and 30 years (P<0.05). Eventually, the isolates of Escherichia coli were the most prevalent cases that carried XDR (5.4%) and MDR (39.7%). Conclusions: In general, it is extremely alarming to increase XDR and MDR uropathogens. This bacterial resistance can be prevented through control measures that limit the spread of resistant bacteria and the regular monitoring of this resistance phenotype of uropathogens, along with the rational use of antimicrobial therapy.

Highlights

  • The resistance pattern of uropathogens is increasing very rapidly because of the unsorted, insufficient, and incoherent usage of antibiotics

  • A number of 2 1167 urine samples were collected in this study, among which 2469 (11.66%) and 18698 (88.34%) were found bacteriologically positive and negative, respectively

  • A higher number of males were found in the age groups of ≤10 and > 60 to ≤90 years and a higher number of females were found within the age groups of 10 to 60 and ≥90 years as compared to males

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Summary

Introduction

The resistance pattern of uropathogens is increasing very rapidly because of the unsorted, insufficient, and incoherent usage of antibiotics. The aim of this study was to evaluate the prevalence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) uropathogens which were isolated from the urinary tract infection (UTI) cases in Dhaka, Bangladesh. Conclusions: In general, it is extremely alarming to increase XDR and MDR uropathogens. This bacterial resistance can be prevented through control measures that limit the spread of resistant bacteria and the regular monitoring of this resistance phenotype of uropathogens, along with the rational use of antimicrobial therapy. According to Magiorakos et al,(1) this pattern occasionally extends to multidrug-resistant (MDR) or extensively drug-resistant (XDR) or even pandrug drug-resistant (PDR). In the third world country like Bangladesh, the rate of UTI patients is high due to poor hygiene, long time catheterization, uncontrolled sexual intercourse, pregnancy, spermicidal contraception, and the like [3,4,5,6]

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