Spectrum and Antibiotic Resistance Pattern of Bacteria Causing Urinary Tract Infections (UTI) in a Tertiary Care Hospital

Abstract

Background: Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians particularly in developing countries. Current knowledge on antimicrobial resistance pattern is essential for appropriate therapy. The aim of the present study was to identify the causative organisms for UTI and to determine the antibiotic susceptibility pattern of organisms causing UTI.
 Method: This cross sectional study was carried out in the department of Microbiology, Sir Salimullah Medical College, Dhaka, from a period of January 2014 to December 2014.
 Results: Out of 2136 clinical sample of urine, 430 (20.1%) showed significant bacterial growth. Escherichia coli was the commonest urinary pathogen (76.3%), followed by Pseudomonas spp. (7.9%), Proteus spp. (7.2%), Klebsiella spp., Citrobacter spp. (1.9% each) and Staphylococcus aureus (1.6%). Isolated uropathogens showed highest resistance for Amoxycillin (86%-97%) and Cefradin (71%-100%), resistance rate for other commonly used antimicrobial agents was high; Cefixime (52%-85%), Ceftriaxone (50%-71%), Ciprofloxacin (50%-88%), Cotrimoxazole (50%-75%), Gentamicin (57%-75%) and Nitrofurantoin (43%-100%), while uropathogens were least resistant to Imipenem (0%-15%) and Amikacin (0%-29%).
 Conclusion: Due to high degree of resistance to commonly used antimicrobials to treat UTI, routine monitoring and evaluation studies should be conducted to update physicians’ knowledge about most effective antibiotics for treatment of UTI.
 Journal of Surgical Sciences (2019) Vol. 23 (1) : 13-18

Prevalence and antimicrobial sensitivity profile of uropathogens in a tertiary care hospital of Dhaka city

“…A study done in Bangladesh reported the prevalence of Klebsiella species, Pseudomonas species and Proteus species were 1.9%, 7.9% and 7.2% respectively and these finding did not correlate with our study 29 . In contrary to our observation, various studies done in different countries reported Klebsiella species as second most common isolate 8,11,25,30 species and Enterococcus species were 12%, 7% and 6% respectively and these observation did not match with our findings 32 .…”

“…In contrary to our finding, higher growth rate was observed in other studies done in Bangladesh by Haque et al, (42.66%) and in India by Mishra et al, (43.61%) 27,28 . In our study, the rate of growth was relatively low in comparison to above two studies and the reason might be due to prior antibiotic therapy before submitting the urine sample, incomplete dose of antibiotic and clinical conditions like non gonococcal urethritis or other conditions that mimic UTI 29 .…”

“…In present study in case of cephalosporin group of drugs, cefradine showed 6.67%, 23.57%, 13.87% and 85.71% sensitivity, cefuroxime showed 28.48%, 45.71%, 33.58% and 71.43% sensitivity, ceftriaxone showed 34.82%, 59.29%, 48.18% and 85.71% sensitivity, ceftazidime showed 37.37%, 55.00%, 47.45% and 85.71% sensitivity to Escherichia coli, Klebsiella species, Enterobacter species and Proteus species respectively. Low sensitivity to the above mentioned drugs observed in various studies done in India, Pakistan and Bangladesh 10,11,27,29 . The reason behind the low rate of sensitivity to different generations of cephalosporin may be caused by ESBL producing organisms.…”

“…Similar to our study low rate of sensitivity to aztreonam was observed in a study done in Pakistan 11 . Extensive clinical practice of the above mentioned drugs might be one of the causes of lower rate of sensitivity to the drugs 29 .…”

The findings of Antimicrobial Resistance Surveillance in Bangladesh (2016-2020)

“…Even though among the collected samples, urine was the highest in number, it yielded only 19% growth. A study done in a tertiary hospital in Bangladesh from outdoor and indoor sample it yielded similar result where 20.1% showed significant growth of bacteria (Afroze et.al, 2019).…”