Recent Trend in the Antimicrobial Resistance Pattern of Urinary Pathogens in a Tertiary Care Hospital

Abstract

Introduction: Antibiotic resistance is a worldwide problem. Organisms are developing resistance not only to commonly used antibiotics but also to high end and less commonly used antibiotics. Aim: The present study has been designed to find out the recent trend of antibiotic resistance profile of uropathogens as urinary tract infection is one of the commonest infections among outdoor and indoor patients. This will help clinicians to select most appropriate antibiotics to treat their patients empirically. This will also help in not only preventing the development but also reducing the spread of antibiotic resistance. Material and Methods: The study was conducted in the Microbiology Department, F.H. Medical College, Etmadpur, Agra, India, from March 2019 to August 2019. Mid-stream urine samples were collected from patients and transported within an hour and were inoculated on blood agar and MacConkey agar. After incubation at 37°C for 24 h, organisms were identified and sensitivity test was done by Kirby Bauer's disc diffusion method using Mueller Hinton Agar. Results: Members of the Enterobacteriaceae family showed resistance to almost all groups of antibiotics except piperacillin-tazobactam, imipenem, and nitrofurantoin while gram-positive organisms were found to be sensitive only to vancomycin, teicoplanin, linezolid, and nitrofurantoin. Situation with nonfermenters (Pseudomonas aeruginosa and Acinetobacter spp.) was alarming as they were found resistant to ceftazidime, cefepime, piperacillin, gentamicin and ciprofloxacin, and also significant resistance with imipenem was seen. Only colistin, polymyxin B and piperacillin-tazobactam showed satisfactory results and could be considered for use in empirical treatment. Conclusion: Present study shows how serious the problem of increasing antibiotic resistance is and emphasizes the need of continuous surveillance of antibiotic susceptibility of uropathogens that will help to formulate an effective antibiotic policy to guide the clinicians.