Antibiotic sensitivity pattern to urinary tract infections in a tertiary care hospital in South India

Authors

  • Shanmugapriya S. Department of Pharmacology, PSG Institute of Medical Sciences and Research, Coimbatore 641004, Tamilnadu, India
  • Saravanan T. Department of Medicine, PSG Institute of Medical Sciences and Research, Coimbatore 641004, Tamilnadu, India
  • Janani K. Final year MBBS student, PSG Institute of Medical Sciences and Research, Coimbatore 641004, Tamilnadu, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20172239

Keywords:

Antibiotics, Culture and sensitivity, Escherichia coli, Urinary tract infection

Abstract

Background: Urinary tract infection (UTI) is one of the most common bacterial illnesses and hence one of the most important indications for antibiotic treatment. Current knowledge of the common organisms implicated in causing UTI in the local community and surveillance to monitor the changes in susceptibility of uropathogens are imperative to ensure appropriate therapy. The study objectives were to assess the proportion of UTI caused by each of the common urinary pathogens, to study the antibiotic drug sensitivity patterns by analyzing the culture and sensitivity reports and to identify the drugs which would be potentially favourable candidates for empirical therapy in the study locale.

Methods: This hospital based cross sectional study was done by collecting the data from case records of patients who attended OPD or were admitted with diagnosis of UTI during the study period.

Results: Escherichia coli was the single most important cause of UTI, accounting for 70% of the infection among the studied subjects, amongst which 55% was extended spectrum beta-lactamase producing organisms. A pattern of increased susceptibility to higher antibiotics like ertapenem, tigecycline and decreased sensitivity to fluroquinolones was evident. In addition, nitrofurantoin was found to be one of the antibiotics to which most of the organisms were susceptible (85%) favouring its use in empirical therapy of UTI.

Conclusions: The pattern of accentuated susceptibility to higher antibiotics in the face of declining trend in the sensitivity to commonly used antibiotics necessitates promoting awareness on the need for rational prescribing of antibiotics among clinicians.

References

Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community acquired urinary tract infections in JNMC Hospital, Aligarh, India. Ann Clinical Antimicrob, 2007 Mar 23;6:4.

Fasugba O, Gardner A, Mitchell BG, Mnatzaganian G. Ciprofloxocin resistance in community and hospital acquired Escherichia coli urinary tract infections: a systematic review and meta analysis of observational studies. BMC Infec Dis, 2015 Nov 25;15(1):545.

Cullen IM, Manecksha RP, McCullagh E, Ahmad S, O’Kelly F, Flynn RJ, et al. The changing pattern of antimicrobial resistance within 42,033 Escherichia coli isolates from nosocomial, community and urology patient-specific urinary tract infections, Dublin, 1999-2009. BJU Int. 2012 Apr;109(8):1198-206.

Najar MS, Saldanha CL, Banday KA. Approach to urinary tract infections. Indian J Nephrol. 2009 Oct;19(4):129-39.

Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012;366:1028-37.

Ferdosi-Sh E, Javanian M, Moradian KM. Resistance patterns of Escherichia coli causing urinary tract infection Caspian J Intern Med. 2015;6(3):148-51.

De Lastours V, Foxman B. Urinary tract infection in diabetes: epidemiologic considerations. Curr Infect Dis Rep. 2014 Jan;16(1):389.

Harwalkar A, Gupta S, Rao A, Srinivasa H. Prevalence of virulence factors and phylogenetic characterization of uropathogenic Escherichia coli causing urinary tract infection in patients with and without diabetes mellitus. Trans R Soc Trop Med Hyg. 2015 Dec;109(12):769-74.

Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269-84.

Ferdosi-Shahandashti E, Javanian M, Moradian-Kouchaksaraei M, Yeganeh B, Bijani A, Motevaseli E, et al. Resistance patterns of Escherichia coli causing urinary tract infection. Caspian J Intern Med. 2015;6(3):148-51.

Gill MM, Usman J, Hassan A, Kaleem F, Shaheen N. In vitro susceptibility pattern of extended spectrum β-lactamase producing gram negative bacilli against tetracyclines. J Ayub Med Coll Abbottabad. 2015 Oct-Dec;27(4):788-90.

Veve MP, Wagner JL, Kenney RM, Grunwald JL, Davis SL. Comparison of fosfomycin to ertapenem for outpatient or step-down therapy of extended-spectrum β-lactamase urinary tract infections. Int J Antimicrob Agents. 2016 Jul;48(1):56-60.

Beveridge LA, Davey PG, Phillips G, McMurdo ME. Optimal management of urinary tract infections in older people. Clin Interv Aging. 2011;6:173-80.

Cunha BA, Cunha CB, Lam B, Giuga J, Chin J, Zafonte VF, Gerson S. Nitrofurantoin safety and effectiveness in treating acute uncomplicated cystitis (AUC) in hospitalized adults with renal insufficiency: antibiotic stewardship implications. Eur J Clin Microbiol Infect Dis. 2017 Feb 2.

Hooton TM. The current management strategies for community-acquired urinary tract infection. Infect Dis Clin North Am. 2003 Jun;17(2):303-32.

Downloads

Published

2017-05-23

How to Cite

S., S., T., S., & K., J. (2017). Antibiotic sensitivity pattern to urinary tract infections in a tertiary care hospital in South India. International Journal of Basic & Clinical Pharmacology, 6(6), 1445–1450. https://doi.org/10.18203/2319-2003.ijbcp20172239

Issue

Section

Original Research Articles