Clinical Utility of Antibiotic against Uropathogen Isolated at a Tertiary Care Hospital of Dhaka City

Abstract

Background: The antibiotic sensitivity pattern of uropathogenic bacteria is varied with different frequency. Objective: The purpose of the study was to determine the pattern of antibiotic sensitivity against uropathogens isolated from a tertiary care hospital of Dhaka City. Methodology: A cross-sectional study was conducted in the Department of Microbiology at Shaheed Suhrawardy Medical College, Dhaka, Bangladesh during period of January 2016 to December 2016. Among 307 consecutive urine samples were collected from patients of UTI in the microbiology laboratory. Samples were mid-stream urine specimens obtained by clean catch method received from various outpatient departments and inpatient wards were transported to the microbiology laboratory in sterile leak proof container were processed immediately. Bacteria were isolated and identified by standard laboratory procedure. Results: Of the 307 urine samples processed 170(55.4%) gave significant growth of pathogens. The prevalence of UTI is high among females (58.2%) than males (41.8%). The commonest isolates were Escherichia coli (71.2%), Pseudomonas (12.4%), Staphylococcus aureus (10.6%), Acinotobactor (4.1%) and Klebsiella (1.8%). Majority (92.4%) of (uropathogens) isolates were found to be MDR. Conclusion: The study revealed that E. coli is the predominant uropathogens of UTIs.

Antimicrobial Susceptibility Pattern of Uropathogens Isolated at a Private Hospital in Khulna, Bangladesh

“…This is in agreement the with study of Khanam et al, who also reported a much lower sensitivity pattern of GNB towards Amoxiclav, azithromycin & cefuroxime. 1 Isolated GNB showed poor sensitivity to Ciprofloxacin (Klebsiella & pseudomonas-44.4%, Enterobacter & Proteus-50%), except E. coli which showed slightly higher sensitivity (64%), which is very much consistent with the findings of Sohely et al 16 E. coli, Klebsiella & proteus showed relatively higher sensitivity to Levofloxacin (70%, 61.1% & 100% respectively) but sensitivity pattern of Enterobacter & Pseudomonas towards Levofloxacin was as low as their sensitivity to ciprofloxacin. This is also true for the study done by Ritu Saha et al 7 & Nahar et al 24 The present study showed that Klebsiella & Proteus had lower sensitivity to nitrofurantoin ( 26 , which is again in agreement with our study.…”

“…A study at a tertiary care hospital in Dhaka, Bangladesh also showed female predominance (58.2%) among culture-positive UTI patients. 1 Ascending infection due to short urethra, the wrong practice of cleaning the perineum forward from the anus to vulva & sexual intercourse may be responsible for this higher frequency of UTI in females. 7 Longer urethra & presence of some natural antimicrobial substances in the prostatic fluid may explain the lower frequency of UTI in the male population.…”

“…Urinary tract infection (UTI) remains one of the most frequently encountered infectious diseases in medical practice, occurring from neonatal to geriatric age group. 1 It acts as a major cause of morbidity in both community & hospital settings affecting around 405 million people globally 2 with nearly 150 million diagnosed cases each year, costing the global economy over 6 billion US dollars. 3 UTI also accounts for more than 40% of the total cases of nosocomial infections reported by acute care hospitals & 66% to 86% of these infections are caused as an aftereffect of instrumentation of the urinary tract, mainly catheterization.…”

“…7 In addition, the pattern of antimicrobial susceptibility of uropathogens is regularly changing due to ever-increasing uses of antibiotics for the treatment of different variety of infections outside the urinary tract. 1,11 Bacteria producing extended-spectrum beta-lactamases (ESBLs) are constantly increasing in the population, which shows resistance to most of the broad-spectrum antibiotics except carbapenem. 12 An alarming picture has been reflected by a recent study in Bangladesh, which demonstrated more than 75% of the E. coli causing UTIs are resistant to third-generation cephalosporins.…”

“…Urine culture was done by semi-quantitative method on MacConkey agar, Blood agar, and Chromogenic media by using calibrated loops and incubated aerobically for 24 hours at 37°C. 1,7 A routine microscopic examination of all urine samples was done to count pus cells. If no colony appeared after 24 hours of incubation, those culture plates were further incubated for 48 hours.…”