RETROSPECTIVE STUDY OF THE SPECTRUM AND ANTIBIOTIC RESISTANCE OF UROPATHOGENS ISOLATED FROM HOSPITAL AND COMMUNITY PATIENTS

Research Article
B.J. Deepthy*,Gogi SuresH and M.Saleel
DOI: 
xxx-xxxx-xxx
Subject: 
Medical
KeyWords: 
Uropathogens, Urinary tract Infection, UTI, Antimicrobials, UPEC
Abstract: 

Urinary tract infections (UTI) are the most common infection encountered in clinical practice, amongst community and hospital patients. Knowledge of the aetiology and antimicrobial susceptibility patterns of uropathogens is important in order to determine the best empiric treatment option This retrospective study was conducted to evaluate the spectrum of microbial aetiology and antibiotic resistance pattern of the uropathogens that causes urinary tract infections to both community as well as hospital patients over a one year period. The clinical data of 827 patients with positive urine culture were collected for the study. The data were from samples collected between October 2012 to September 2013.The aetiology of urinary tract infection and antimicrobial susceptibility pattern were analysed. Out of the 827 urine samples, 635 (76.78%)were either sterile or showed insignificant growth, 192 (23.21%) showed significant growth. The overall most common isolates were: Escherichia coli, accounting for 82 (42.7%)isolates, followed by Klebsiellapneumoniae, 12 (6.25%), Acinetobacter sp.,9(4.68%) Citrobacter sp.,7 (3.64%) and Staphylococcus aureus and Candida sp.,5 each (2.6%).The ratio of gram negative to gram positive bacteria was 13.8:1.It is also found that both genders at the specific age group of 50-70 were more prone to infection. Out of the 192 cases 103 were out patients and 89 were admitted cases.Antibiotic resistance analysis revealed the multiple drug resistance nature of the isolates to the commonly used antibiotics. Nitrofurantoin provided the widest coverage amongst all the antibiotics tested followed by amikacin, and co-trimoxazole. High resistance was noted among Ampicillin and Amoxicillin /Clavulanic acid. It is also noted that out of the 192 cases 89 patients had severe urinary tract infection which required admission. The culture positive rate for uropathogens was high, with a greater incidence among females. E.coli was the most common aetiological agent and remained susceptible to nitrofurantoin. The obtained results suggest that antibiotic selection for empirical treatment should be based on individual drug –sensitive test results. There is also an urgent need to develop a new combination of chemotherapeutic agents and awareness on antibiotic use for the effective UTI management. These data can serve as a basis to develop area specific guidelines for the empirical treatment of UTIs.