Current antimicrobial susceptibility pattern of uropathogens in a maternal and child health care hospital in Bangladesh

Authors : Ritu Saha, Afzalunnessa Binte Lutfor, Arpita Deb, Taskina Akhter, Tamanna Sultana

DOI : 10.18231/j.ijmr.2019.029

Volume : 6

Issue : 2

Year : 2019

Page No : 135-141

Introduction: Urinary tract infection is still one of the most common infections among all age groups. The causative microorgnisms of UTI and their sensitivity to different antibiotics varies in different areas, and changes with time. This necessitates periodic studies of the causative uropathogens and their antibiotic sensitivity pattern.
Aim: To observe the profile of common uropathogens and their antibiotic sensitivity patterns to commonly used antimicrobial agents.
Materials and Methods: A contemplative study was done at the department of Microbiology of Ad-din Women’s Medical College, Dhaka (AWMCH), Bangladesh, during January to December, 2017. Clean-catch midstream urine samples were collected from 7139 suspected urinary tract infection patients of different age and sex groups. Uropathogens were identified by standard microbiological techniques and antimicrobial susceptibility pattern was determined by Kirby Bauer Disc diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines.
Result: In this study, Out of 7139 patients, 1664 (23.3%) were growth positive for urine cultures. Majority of the patients (88.5%, 6315/7139) were female. The predominant isolate was E. coli 712 (42.8%), followed by Coagulase negative Staphylococcus (CONS) 589 (35.4%), Acinetobacter 126 (7.5%), Enterobacter spp. 72 (4.3%), Klebsiella spp. 62 (3.7%), Enterococcus spp. & Proteus spp. 16 (1.9%). Imipe­nem (92%), amikacin (83.8%), piperacillin- tazobactum (85.4%), gentamycin (69.4%), levofloxacin (65.6%) shows higher sensitivity to Gram negative bacteria, whereas high resistance to ampicillin (17%), cephradin (11.8%), cotrim (26%) and amoxiclav (28%) were observed. On the other hand, Gram positive bacteria showed high resistance to nalidixic acid (70-95%), erythromy­cin (68-90%), and high sensitivity to nitrofurantoin, meropenem, vancomycin and linezolid. Vancomycin, linezolid and nitrofurantoin for Gram positive bacteria and amikacin, meropenem, pipercillin tazobactam, and colistin for Gram negative bacteria are still useful. As an empirical antibiotic against Gram negative organisms, amoxyclav is less effective as only 20% pathogens were susceptible. Both Gram positive and negative bacteria are highly resistance to quinolones, nitrofurantoin and cephalosporins with few exceptions.
Conclusion: Empiric antimicrobial agents should be selected on the basis of current antibiotic sensitivity pattern of the uropathogens prevalent in that area.

Keywords: Uropthogens, Urinary tract infection, Current Antimicrobial susceptibility pattern.


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