Antibiotic resistance pattern of urine culture isolates from patients with community acquired UTI

 

 

Abstract              Background: Urinary tract infections (UTI) are among the most common infections in outpatients and in-patients. In almost all cases, empirical antibiotic treatment is started before the results of urine culture are available. For this reason, knowledge of the causative agents of UTIs and their antibiotic resistance patterns in specific institutional settings and geographical areas may help clinicians in choosing the appropriate empirical antimicrobial treatment. The data will also help antibiotic stewardship policies of the hospital. The objective of this study was to determine the Antibiotic resistance pattern of urine culture isolates from patients with UTI (Community acquired). Materials and Methods: The study included adult subjects above 18 years who came to OPD with symptoms of UTI (dysuria, frequency, urgency and suprapubic tenderness with or without fever) and/or patients in whom physicians suspected Uncomplicated Community acquired UTI. Urine samples were processed in Microbiology Laboratory for Microscopy and Culture Identification and Antibiotic Susceptibility Test by VITEK COMPACT 2 method. Results: The total number of patients was 50. 31 (62%) were males and 19 (38%) were females. The commonest organism to be isolated was E. coli (72%) followed by Klebsiella pneumoniae (18%), Citrobacter koseri (4%), Pseudomonas aeruginosa (2%), Serratia marcescens (2%) and Enterobacter cloacae (2%). Resistance to Ampicillin, Cefuroxime axetil, and Ciprofloxacin was high. Amikacin and Nitrofurantoin had least resistance. E coli showed maximum resistance to Ampicillin and Ciprofloxacin and least resistance to Nitrofurantoin. Klebsiella pneumoniae showed maximum resistance to Ampicillin, Cefuroxime axetil and Cotrimoxazole and least resistance to Nitrofurantoin and Amikacin. Conclusion: This study shows that E Coli is the commonest organism isolated in our patients with community acquired UTI. This study showed a pattern of resistance towards Fluoroquinolones, Cephalosporins and least resistance to Amikacin and Nitrofurantoin. Since Amikacin is a parenteral antibiotic, Nitrofurantoin could be used as a first choice Oral Empirical Antibiotic for treating uncomplicated community acquired UTI (pending culture sensitivity reports) in patients attending our OPD. However, urine culture and sensitivity testing is necessary in all cases and antibiotic therapy has to be modified based on the isolate and sensitivity report.

Key Word: Urinary tract Infection; Antibiotic resistance; Urine culture