Uropathogens and their Susceptibility to Common Antibiotics in Adult Patients Presenting to the Emergency Department of a Tertiary Care Hospital in Pakistan

Abstract

OBJECTIVE To identify the prevalence of uropathogens and their susceptibility patterns to different antibiotics in adult patients presenting to the emergency department with lower urinary tract symptoms so that treating physicians can identify common pathogens and select a reasonable empirical antibiotic if needed. METHODOLOGY The study is a retrospective chart review conducted in the emergency department of Shifa International Hospital, Islamabad, Pakistan. All the patients diagnosed with urinary tract infection through dipstick in the emergency department whose urine cultures were positive were included in the study. The chart review was done from January 1st, 2018 to 31st December 2018. RESULTS Out of 203 patients with positive urine dipstick, whose cultures sent from emergency only 64(31.3%) samples showed significant bacterial yield. Most patients included in the study were above 50 years of age (79.7%) with a male predominance (males 36, females 28). The most common organisms isolated was E.coli 44 (68.8%) followed by Klebsiella spp. 09(14%) and Enterococcus spp. 03 (4.7 %) respectively. Antibiotics which were found most sensitive against pathogens in our study included Imipenem (78.1 %), Nitrofurantoin (76.6 %) and Fosfomycin (76.6 %) respectively. On the other hand most of microbial growth was highly resistant to both penicillins (Co-amoxiclave 80.8 %) and cephalosporin (Cefixime 84.4%, Ceftazidime 78.1 %, and Ceftriaxone 81.2 %). Moderately resistance was seen to antibiotics such as Co-Trimoxazole (71.4%), Ciprofloxacin (73.4%) and Gentamicin (48.4%) respectively. A high prevalence of carbapenem resistance (9.4% to imipenem) was also observed in this study CONCLUSION Most uropathogens identified in patients presenting to the emergency department with urinary complains are sensitive to Fosfomycin, Nitrofurantoin, Gentamycin, and Imipenem which may be considered as empirical therapy in our settings.