Urinary Tract Infection in Diabetics - A Five Year Retrospective Study on the Prevalence of Bacterial Isolates and its Antibiotic Susceptibility Patterns in A Tertiary Care Hospital in South India

Jagadeeswaran, G; Ansari, M. Z.; Rajangam, Tolstoy

doi:10.21276/ijcmr.2018.5.4.45

IJCMR

2018

DOI: 10.21276/ijcmr.2018.5.4.45

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Urinary Tract Infection in Diabetics - A Five Year Retrospective Study on the Prevalence of Bacterial Isolates and its Antibiotic Susceptibility Patterns in A Tertiary Care Hospital in South India

G Jagadeeswaran¹,

M. Z. Ansari²,

Tolstoy Rajangam³

Abstract: Introduction: Urinary tract infection (UTI) is almost most common seen infection in the diabetic patient due to various local and systemic immunopathogenetic reasons. This causes multiple renal and extrarenal complications and even death if not intervened early. We aimed to find out the prevalence of different bacteria in urine culture and the antibiotic susceptibility pattern amongst diabetic patients admitted in our hospital and to start empirical antibiotics for early recovery and to prevent complications.

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2024

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Cited by 2 publications

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Prevalence of bacterial isolates and change in their antibiotic susceptibility patterns in urinary tract infections- A five year retrospective study

Prabhala,

Sundaresan,

Varaiya

2024

JCHM

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Urinary Tract Infection (UTI) continues to be one of the commonly occurring infections in medical practice despite the widespread availability of antibiotics. Presence of risk factors like elderly age, diabetes, immune-suppression, and other comorbidity pose a challenge in its treatment. Over the years, the etiology and antibiotic resistance of the uropathogens has been inconsistent. Therefore, it is important to determine the causative agents of UTI and their resistance patterns locally, in each region, so that appropriate empiric therapy can be started before the culture and antibiotic sensitivity results are available. This study aims to highlight the prevalence of uropathogens and determine the antibiotic sensitivity pattern over the period of five years.The urine samples from patients with suspected urinary tract infections (UTI) received in the laboratory at Nanavati Max Super speciality hospital were processed by standard protocol from January 2018 to December 2022. Antibiotic susceptibility test for the bacterial isolates was carried out by the VITEK2 automated system and interpreted as per CLSI guidelines. The data collected over the study period of five years was interpreted by using the WHO Net Antibiotic Susceptibility Surveillance Software in February 2023. From a total of 8068 urine samples received over five years, uropathogens were isolated in 4209 (52.16%) samples. E.coli was the most common isolate causing UTI, with prevalence of 380(46.7%) in 2018 and 480(50.6%) in 2022 of total samples. Amongst gram positive organisms, a rise in Enterococcus species was seen from 41(5%) in 2018 to 87(9%) in 2022, with significantly fewer Staphylococcus species isolated, from 32(4%) in 2018 to 7(0.7%) in 2022. The Enterobacteriaceae showed high sensitivity to Amikacin, Tigecycline and Meropenem all throughout the study. However, rise in resistance to Nitrofurantoin and Fosfomycin, antibiotics commonly used for UTIs, was observed. Also the prevalence of Extended Spectrum of Beta lactamase (ESBL) producers decreased from 213(36%) to 127(17%) with a rise in Carbapenemase producing Enterobacteriaceae from 48(8%) to 298(40%) over the five years study period.Amongst Lactose Nonfermenting gram negative bacilli only 32 % were sensitive to Carbapenems and 37% sensitive to Aminoglycosides.By 2022, Enterococcus species showed an increase in sensitivity to Nitrofurantoin (27%), High level Aminoglycosides (37%), Fluoroquinolones (25%) and Ampicillin (37%).The change in antibiotic sensitivity patterns over time and rise in resistance to antibiotics commonly used in empirical treatment of UTIs warrants the need for regular surveillance, so the physicians can be updated regarding the most prevalent organism and its susceptibility and the empirical treatment for UTIs can be modified accordingly. This can help curb indiscriminate use of antibiotics and development of antibiotic resistance.

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Prevalence of bacterial isolates and change in their antibiotic susceptibility patterns in urinary tract infections- A five year retrospective study

Prabhala,

Sundaresan,

Varaiya

2024

JCHM

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Microbiologic profile and clinical practices in urinary tract infections in a tertiary care center in Southern India

Kiranmala

Johnson

Savio

et al. 2019

J Family Med Prim Care

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Context:Studies reported differences in clinical profiles of urinary tract infections (UTIs) in patients with and without type 2 diabetes mellitus (T2DM). Studies on the impact of the pattern of antibiotic resistance of organisms causing UTI on actual clinical practice are lacking.Objectives:1. To study the clinical and microbiologic profiles of UTIs. 2. To compare treatment given with the prevailing antimicrobial sensitivity.Settings and Design:This is a cross-sectional study conducted in a tertiary care hospital.Methods and Materials:Retrospective chart review of inpatients with UTI (N = 200, 100 each of patients with and without T2DM), aged >18 years with a positive urine culture.Statistical Analysis:We used the statistical package SPSS version 17. The categorical variables were analyzed by the Chi-square test. Data were considered significant if P value was less than 0.05.Results:Similar to previous Indian studies, T2DM patients with UTI had significantly more asymptomatic bacteriuria, asymptomatic bacteriuria (32% vs. 6%), previous history of UTI (25% vs. 2%), and prior catheterization (16% vs. 1%). Escherichia coli (E. coli) was the most common organism isolated and showed sensitivity pattern of meropenem > netilmicin > amikacin > nitrofurantoin. Ceftriaxone was the most common empirical therapy given in spite the prevailing low sensitivity of E. coli to it. All ASB cases were treated unlike recommendations.Conclusions:Ceftriaxone is the most common empirical therapy given in spite the prevailing low sensitivity of E. coli to it. Cases of ASB were treated unlike recommendations.

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Urinary Tract Infection in Diabetics - A Five Year Retrospective Study on the Prevalence of Bacterial Isolates and its Antibiotic Susceptibility Patterns in A Tertiary Care Hospital in South India

Cited by 2 publications

References 6 publications

Prevalence of bacterial isolates and change in their antibiotic susceptibility patterns in urinary tract infections- A five year retrospective study

Prevalence of bacterial isolates and change in their antibiotic susceptibility patterns in urinary tract infections- A five year retrospective study

Microbiologic profile and clinical practices in urinary tract infections in a tertiary care center in Southern India

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