Multidrug Resistant Bacteria in Urinary Tract Infection: A Constant Threat to a Tertiary Care Health Set-up in North India

Abstract

Introduction: Urinary tract infections (UTIs) is one of the most common bacterial infections. Irrelevant use of antibiotics has resulted in the emergence of resistant strains. Aims and objective:To identify and look for the antimicrobial resistance pattern of various isolates in a tertiary care teaching hospital.Methods: A retrospective study was conducted in a tertiary level hospital for 4 years (March 2014to March 2018. A total of 41020 urine samples received in the laboratory and 6114 of them diagnosed to be culture positive UTI were processed for Antibiotic sensitivity by the standard microbiological procedure.Results: Out of 6114 culture, positive samples 2829 (46.27%) had significant bacteriuria. Females more affected (52.27%) than males (48.43%). Amongst fermenters (GNF), E.coli (52.7%) was most common followed by Klebsiella spp. (23.65%). Amongst the Gram-positive organisms Enterococcus spp. (3.67%) was more common followed by Staphylococcus saprophyticus (1.44%). While Pseudomonas spp. followed by Burkholderia sp were the common non-fermenters (GNNF). In GNF, imipenem, meropenem and amikacin were most effective drugs whereas, in GNNF, imipenem, meropenem and piperacillin-tazobactam were more effective. Linezolid and vancomycin were the most sensitive antibiotics in Gram-positive isolates. Conclusion:There is increasing resistance to, and nitrofurantoin noted in our study that is frequently considered drugs of choice for empiric therapy. It is important to determine trends in antimicrobials susceptibilities, to formulate local antibiotics policy that will guide the clinicians regarding the empirical choice for UTI to prevent misuse or overuse of antibiotics.Clinical significance: Because of the emerging resistance to the available group of antimicrobials, regular monitoring of the resistance pattern is essential for the clinicians to choose for the best empiric therapy.