Spectrum and Antibiotic Resistance Pattern of Uropathogens Causing Urinary Tract Infection Among Inpatients and Outpatients: An Experience of a Tertiary Care Hospital in Karachi, Pakistan

Abstract

Objective: To determine the spectrum and antibiotic resistance pattern of uropathogens causing urinary tract infection among inpatients and outpatients in a tertiary care hospital in Karachi Methods: This descriptive cross-sectional study was conducted in the Department of Microbiology, Sindh Institute of Urology and Transplant, Karachi, The study was conducted from March 2016 to March 2017 after taking approval from the Hospital Ethics Committee. Urine specimens were analyzed to establish a diagnosis of UTI and identify uropahtogens. The antibiotic susceptibility pattern of uropathogens was studied using disc diffusion method against the following antibiotics; fosfomycin, ampicillin, amoxicillin-clavulanate, nitrofurantoin, cefotaxime, ceftazidime, amikacin, cefoxitin, imipenem and vancomycin. Results: A total of 480 samples of UTI were received during the study period. The average age of patients was 54.79±12.09 years. The majority of samples came out positive from the male gender (65%) and in-patient department (n=400, 83.3%). The highest prevalent microorganism was E.coli (82.1%) followed by Klebsiella spp (14%), Pseudomonas aeruginosa (1%), Proteus mirabilis (1%), Morganella morgannii (1%) and Staphylococcus aureus (0.8%). All microorganisms were highly resistant to augmentin, cefoxitin, cefotaxime, ceftazidime. Only pseudomonas aeruginosa was highly resistant to imipenem (60%). Pseudomonas aeruginosa (100%), E.coli (86.8%) and Klebsiella spp (71.6%) were highly sensitive for Amikacin (100%). Morganella morgannii (80%) and Proteus Mirabilis (40%) were mainly resistant to Fosfomycin. Only E.coli was sensitive to nitrofurantoin (74.1%). Conclusion: The presented study demonstrated that gram-negative bacteria was the most frequent cause of urinary tract infection. Microorganisms showed variable resistance to different antibiotics. The first line of antibiotics should be rationally selected by physicians to treat urinary tract infections.