Retrospective study on susceptibility and resistance pattern of urinary pathogens in a tertiary care hospital

Authors

  • Sudha Ramu Department of Pharmacology, K.A.P.V. Govt. Medical College, Tiruchirapalli, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20194257

Keywords:

Urinary tract infection, Susceptibility and resistance pattern, Antimicrobial agents

Abstract

Background: Indiscriminate and inappropriate use of antimicrobial agents (AMA) resulted in rapid emergence of antimicrobial resistance. Institutional level surveillance program to be carried out to track AMA use. The study was conducted to evaluate the prevalence of uropathogens and their susceptibility and resistance pattern in a tertiary care hospital to revise empirical therapy.

Methods: Urine samples received from the inpatients and outpatients Departments of Mahatma Gandhi memorial hospital for culture sensitivity between January 2018 to December 2018 were included in this study. Data collected from the Department of Microbiology register by using WHONET software. After identification, isolates were tested for antimicrobial susceptibility by the standard Kirby Bauers diffusion method. Descriptive analysis done and results were expressed as percentage.

Results: Out of 3425 samples 68.5% showed no growth, 15.5% normal flora and only 15.9% reported as culture positive. In this study the highest isolate was Escherichia coli (59%) followed by Klebsiella pneumoniae (10.6%), Enterococcus sp. (7%), Staphylococcus aureus (5%), Candid (3.6%), Acinetobactor (3%) and Pseudomonas (2.9%). Uropathogens developed resistance against penicillins, cephalosporins, macrolides and cotrimaxazole.

Conclusions: This study confirms, the frequently prescribed empirical therapy drugs were less susceptible and developed resistance than less frequently prescribed and costly drugs. The current antimicrobial resistance pattern alarms the irrational and excessive use of antimicrobial agents. Hence the treating physicians should revise empirical therapy periodically based on the institutional antibiogram and resistance pattern reported from the laboratory to preserve antimicrobial source for the future generation.

Author Biography

Sudha Ramu, Department of Pharmacology, K.A.P.V. Govt. Medical College, Tiruchirapalli, Tamil Nadu, India

Associate professor

Department of Pharmacology

 

References

Raju SB, Twari SC. Urinary tract infection-a suitable approach. J Indian Acad Clin Med. 2001;2(4):331-7.

Manjunath GN, Prakash R, Vamseedhar Annam KS. Changing trends in the spectrum of antimicrobial drug resistance pattern of uropathogens isolated from hospitals and community patients with urinary tract infections in tumkur and bangalore. Int J Biol Med Res. 2011;2(2):504-7.

Leigh D. Urinary tract infections. In: Smith GR, Easma Charles SF, eds. Topley and Wilsons principles of Bacteriology, virology and immunity, Butler and Tanler Ltd., Frome and London; 1990: 197-214.

Foxman B. Epidemiology of urinary tract infections: Inidence, morbidity and economic costs. Dis Mon. 2003;49:53-70.

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

Kothari A, Sagar V. Antibiotic resistance in pathogens causing community-acquired urinary tract infections in India: a multicenter study. The Journal of Infection in Developing Countries. 2008;2(05):354-8.

Wilson ML, Gaido L. Laboratory diagnosis of Urinary tract infections in adult patients. Clin Infect Dis. 2004;38:1150-8.

Kashef N, Djavid GE, Shahbazi S. Antimicrobial susceptibility patterns of community-acquired uropathogens in Tehran, Iran. J Infection Developing Countries. 2010;4(04):202-6.

Kahlmeter G. An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO• SENS Project. J Antimicrobial Chemotherap. 2003;51(1):69-76.

Acharya A, Gautam R, Subedee L. Uropathogens and their antimicrobial susceptaability pattern in Bharatpur. Nepal Med Coll J. 2011;13(1):30-3.

Brown P, Ki M, Foxman B. Acute pyelonephritis among adults. Pharmacoeconomics. 2005;23(11):1123-42.

Das A, Banergee T. Prevalence of urinary tract infections and susceptibility pattern of uropathogens in women of reproductive age group from North India. J Adv Med. 2015;4(1):5-9.

Chaurasia D, Shrivastava RK, Shrivastava S, Dubey D, Songra M. Bacterial pathogens and their antimicrobial susceptibility pattern isolated from urinary tract infection in a tertiary care centre. Int J Pharma Bio-Sci. 2015;1:20-4.

Obiofu EN, Ige OH, Iroro O. Antimicrobial susceptibility pattern of urinary isolates from outpatients suspected for urinary tract infection. GSC Biol Pharm Sci. 2018;5(3):1-11.

Shanthi B, Selvi R, Madhumathy A. Antimicrobial Susceptibility Pattern of Escherichia coli from Patients with Urinary Tract Infections in a Tertiary Care Hospital. Int J Curr Microbiol App Sci. 2018;7(1):289-94.

Chittagong B. A study of antibacterial susceptibility and resistance pattern of E. coli causing urinary tract infection in Chittagong, Bangladesh. Asian J Biol Sci. 2011;4(7):548-55.

Kibret M, Abera B. Antimicrobial susceptibility pattern of E.coli from clinical sources in Northeast Ethiopia. Afr Health Sci. 2011;11(1):40-5.

De Francesco MA, Ravizzola G, Peroni L, Negrini R, Manca N. Urinary tract infections in Brescia, Italy: etiology of uropathogens and antimicrobial resistance of common uropathogens. Med Sci Monitor. 2007;13(6):136-44.

Varghese A, George S, Gopalakrishnan R, Mathew A. Antibiotic susceptibility pattern of Klebsiella pneumoniae isolated from cases of urinary tract infection in a tertiary care setup. J Evol Med Dent Sci. 2016;5(29):1470-4.

Ullah F, Malik S, Ahmed J. Antibiotic susceptibility pattern and ESBL prevalence in nosocomial Escherichia coli from urinary tract infections in Pakistan. Afr J Biotech. 2009;8(16):3921-6.

Bharti AK, Farooq U, Singh S, Kaur N, Ahmed R, Singh K. Incidence of Enterococcal Urinary Tract Infection and it's Sensitivity Pattern among Patients Attending Teerthanker Mahaveer Medical College and Research Centre, Moradabad, India. Int J Sci Study. 2016;3(12):112-6.

Goel V, Kumar D, Kumar R, Mathur P, Singh S. Community acquired enterococcal urinary tract infections and antibiotic resistance profile in North India. J Lab Phy. 2016;8(1):50.

Onanuga A Awhowho GO. Antimicrobial resistance of staphylococcus aureus strains from patients with urinary tract infections in Yenagoa, Nigeria. J Pharm Bioallied Sci. 2012;4(3):226-30.

Lakshminarayana SA, Chavan SKD, Prakash R, Sangeetha S. Bacterial pathogens in urinary tract infection and antibiotic susceptibility pattern from a teaching hospital, Bangaluru, India. Int J Curr Microbial App Sci. 2015;4(11):731-6.

Toner L, Papa N, Perera M, Aliyu SH, Dev H, Lawrentschuk N, et al. Staphylococcus aureus urinary tract bacteriuria: single-institutional antibiotic susceptibility trends over a decade. Bladder. 2017;4(3):30.

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Published

2019-09-25

How to Cite

Ramu, S. (2019). Retrospective study on susceptibility and resistance pattern of urinary pathogens in a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 8(10), 2211–2215. https://doi.org/10.18203/2319-2003.ijbcp20194257

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Original Research Articles