Antibiotic susceptibility in commonly isolated pathogens from urinary tract infection in a cohort of subjects from low socioeconomic strata.

Abstract

Background and Objective:Urinary tract infection is one of the commonest infections seen in clinical practice. Lack of compliance and unjustified antibiotic prescriptions has resulted in bacterial resistance and is proving as a major challenge in the management of these infections. Our aim was to identify the sensitivity pattern of commonly used antibiotics against urinary tract infections so as to suggest an improvised line of action against bacteria causing urinary tract infections’.Method:This was a hospital based cross sectional study extended over a period of four months. Patients were recruited from outpatients department of a tertiary care hospital in an industrial area of Karachi. Adult patients with symptomatic and documented UTI in urine detailed report (pus cells >10) were enrolled after informed consent. A clean catch midstream urine was collected for culture and sensitivity testing using the standard microbiological procedure. Data is analyzed on SPSS 16.Results:A total of 184 samples were collected in 4 months. The Male to Female ratio was 1:2 (n=58/126) with mean age 48.5±12 years. 83(45.6%) patients were between 45-60 years. Most common isolated pathogen was Eschericia coli 108(59%) followed by staphylococcus aureus 30(16.4%) and Klebsiella 20(11%). 55(30%) pathogens showed sensitivity to 4-6 antibiotics, 22(12%) strains to 7-9 antibiotics, 33(18%) were sensitive to ≤3 drugs and in 3(1.6%) patients resistance to all antibiotics is seen. The more resistant pathogens were sensitive to intravenous antibiotics alone.Conclusion:In this low socioeconomic cohort with UTI nearly half the isolated pathogens has shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use. Therefore, a revised line of management should be developed locally in accordance with the susceptibility pattern of the urinary pathogens to avoid further resistance as well as morbidity of the patient.

Microbiology and Drug Resistance of Pathogens in Patients Hospitalized at the Nephrology Department in the South of Poland

“…E. coli susceptibility to fluoroquinolones in the current study ranged from 60.3% (norfloxacin) to 70.4% (ciprofloxacin) which was similar to the rates observed in Brazil and Korea (Reis et al 2016;Park et al 2017). Another study reported that E. coli was least sensitive to cephalosporins (7.0-34.0%) and fluoroquinolones (26.0-28.0%); however, a study was conducted on a population from low socioeconomic strata (Kidwai et al 2017). A good empirical choice seems to be nitrofurantoin but a study carried out in Poland showed a high proportion of resistance to nitrofurantoin among E. coli isolates (Stefaniuk et al 2016).…”

Antibiotic Resistance Pattern of Escherichia coli and Klebsiella Species in Pakistan: A Brief Overview

“…It was also highlighted recently that emergence of MDR bacteria are on raise and 77.5% of all the screened isolates were resistant to three or more than three of the tested antibiotics [23]. A report from Sindh province of Pakistan showed that nearly half of the isolates from UTI have shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use [24]. A large scale retrospective study from Karachi analyzed the data of 27,852 blood cultures over the period of four years (2010, 2012, 2014 and 2015) and the results showed that Klebsiella spp.…”

Emergence of Antibiotic Resistance in Pakistan; A Clear Problem for Future

“…Multi drug resistance (MDR) is increasing in Pakistan and it has been highlighted in a study that 77.5% of all the screened isolates were resistant to three or more than three of the tested antibiotics [10]. Different reports regarding the development of antibiotic resistance in Pakistan confirm the drastic increase of antibiotic resistance or even the development of MDR across the country [11][12][13][14][15][16][17][18].…”