Antibiotic susceptibility pattern of uropathogens in urinary tract infection in a tertiary care hospital

Abstract

Background: Urinary tract infection (UTI) is one of the most common infectious diseases at the community level and particularly in developing countries, overwhelmed with healthcare and economic constraints. Urinary tract infection can be called pyelonephritis (kidney infection), or cystitis (bladder infection). UTI bacteria include Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae),
Citrobacter species, Enterobacter species, Pseudomonas aeruginosa (P. aeruginosa), and Staphylococcus species. Aims & Objectives 1. To describe the bacteriological profile.  2. To identify the antimicrobial resistance (AMR) pattern. 3. To find the demographic characteristics associated with the presence of bacterial growth and multidrug resistance (MDR) in adult urine samples undergoing culture and drug susceptibility testing. Method of study: This was a hospital-based, cross-sectional study using routine laboratory records. The susceptibility of antibiotics and resistance pattern of bacteria responsible for UTI at a Tertiary care institution, MGM Hospital Warangal, Telangana, India, were examined from 2020 to 2023 in order to determine the adequacy of empirical therapy. Using a checklist, three years of urine culture findings, biochemical test results, and antibiotic susceptibility test results of isolates were acquired from the medical microbiology laboratory registration. Infection reports from people of all ages and genders were considered. SPSS version 23 was used to examine, input, and analyse data. We provided our findings in the form of descriptive tables and graphs.
Results: With a prevalence rate of 72%, Escherichia coli was the most common uropathogen, followed by Klebsiella spp. (20%) and Pseudomonas spp. (8%). Penicillin was the least effective against UTIcausing E. coli, with fourth generation cephalosporins showing the greatest vulnerability. Klebsiella spp., another common uropathogen, was most resistant to broad-spectrum penicillin, followed by
aminoglycosides and third generation cephalosporin. The infection incidence was approximately same in both sexes, but was greatest in those over the age of 60.
Conclusion: In our hospital, the antibiotic resistance trend of two major UTI pathogens, E. coli and Klebsiella spp., appears to be comparable to that reported in other regions of the country. Broadspectrum penicillin resistance was discovered to be greater than 50%. In South India, fourth generation cephalosporins and macrolides appear to be the drugs of choice for treating UTIs. Furthermore, enhanced infection incidence log keeping is required in hospitals to permit frequent tracking of the occurrence of antibiotic resistance patterns, as such levels vary.