Changing Prevalence and Antimicrobial Susceptibility Profiles by Uropathogens : A Study in India

Abstract

AIM:To analyse the changing spectrum of uropathogens isolated from clean catch midstream urine samples and to evaluate the antibiotic sensitivity pattern & Multi drug resistance of those isolates. MATERIALS AND METHODS: All the urine samples collected in sterile container were received during the study period from Jan 2013 to Dec 2014 were processed & all the pathogenic isolates were identified as per the standard guideline. Antibiotic sensitivity was performed for the identified pathogens according to CLSI standards. RESULTS: A total 2306 urine specimens were processed and 43.06% showed significant bacteriuria among which 31.78% revealed GNB bacteriuria and 11.28% revealed GPC bacteriuria. The most frequently isolated pathogens were E.coli (27.8%), Klebsiella (16.7%) & Pseudomonas (6.0%) among GNB and Enterococci (11.9%) followed by CONS (8.6%) among GPC. Sensitivity tested against various antimicrobials to gram negative bacilli showed maximum sensitivity against Imipenem, Nitrofurantoin and Amikacin in order of sensitivity. Gram positive cocci showed maximum sensitivity against Vancomycin, Nitrofurantoin and Gentamicin respectively. Multidrug resistance was observed in all isolated pathogens. CONCLUSION: In this study we observed that there was a gradual shift in the prevalence of the isolated uropathogens and its antimicrobial sensitivity pattern. The reasons for this shift can be framed out as either more frequent and unnecessary usage of antibiotics or prescribing newer antibiotics with newer combinations for faster recovery of infections. Overall, both gram positive and gram negative organisms were most susceptible to Nitrofurantoin (Apart from Vancomycin in gram positives).