ANTIMICROBIAL RESISTANCE PATTERNS IN COMMUNITY ACQUIRED URINARY TRACT INFECTIONS
AbstractBackground: Urinary tract infection (UTI) is the most frequent disease for which patients seek medical care. The antimicrobial agents causing UTI and their sensitivity patterns have remarkably changed throughout the world over the past few years. Hence, the present study was designed to explore the uropathogens and their susceptibility to various molecules in our region. Methods: This descriptive cross sectional study was conducted at Medical C Unit of Ayub Teaching Hospital, Abbottabad from January 2015 to January 2016. Patients with clinical features of UTI were evaluated using Urine R/E and Urine culture and sensitivity. Ten antibiotics were checked for susceptibility. Results were analysed using SPSS 17. Results: A total of 630 patients presented with urinary complaints. Of these, 236 patients had more than 8-10 pus cells on urine R/E. They were further evaluated using culture and sensitivity and positive culture was obtained in 75 patients. Of these 34 (45.3%) were males and 41 (54.7%) were females. E Coli was the predominant isolate being present in 49 (65.3%) patients. This was followed by Klebsiella in 9 (12%) patients. Tazobactam-piperacillin and cefoperazone-sulbactam were the most sensitive drugs having overall sensitivity of 96% and 93.3% respectively. The isolates were highly resistant to Fluoroquinolones 77.3% followed by Penicillins 72% and TMP-SMX 69.3%.Conclusion: Antibiotic sensitivity patterns have enormously changed over the past decade. Newer agents are quite efficacious but their use should be highly judicious to prevent the development of resistance to these molecules.Keywords: Urinary tract infection; sensitivity; resistance; antimicrobials
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.
Ejrnæs K. Bacterial characteristics of importance for recurrent urinary tract infections caused by Escherichia coli. Dan Med Bull 2011;58(4):B4187.
Afriyie DK, Gyansa-Lutterodt M, Amponsah SK, Asare G, Wiredu V, Wormenor E, et al. Susceptibility pattern of uropathogens to ciprofloxacin at the Ghana police hospital. Pan Afr Med J 2015;22:87.
Gupta K, Hooton TM, Stamm WE. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med 2001;135(1):41–50.
Nicolle LE. Urinary tract infection: traditional pharmacologic therapies. Dis Mon 2003;49(2):111–28.
Talan DA, Naber KG, Palou J, Elkharrat D. Extended-release ciprofloxacin (Cipro XR) for treatment of urinary tract infections. Int J Antimicrob Agents 2004;23(Suppl 1):S54–66.
Manges AR, Natarajan P, Solberg OD, Dietrich PS, Riley LW. The changing prevalence of drug-resistant Escherichia coli clonal groups in a community: evidence for community outbreaks of urinary tract infections. Epidemiol Infect 2006;134(2):425–31.
Kahan NR, Chinitz DP, Waitman DA, Dushnitzky D, Kahan E, Shapiro M. Empiric treatment of uncomplicated urinary tract infection with fluoroquinolones in older women in Israel: another lost treatment option? Ann Pharmacother 2006;40(12):2223–7.
Kumar MS, Lakshmi V, Rajagopalan R. Related Articles, Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian J Med Microbiol 2006;24(3):208–11.
Khan AU, Musharraf A. Plasmid mediated multiple antibiotic resistance in Proteus mirabilis isolated from patients with urinary tract infection. Med Sci Monit 2004;10(11):598–602.
Lu PL, Liu YC, Toh HS, Lee YL, Liu YM, Ho CM, et al. Epidemiology and antimicrobial susceptibility profiles of Gram-negative bacteria causing urinary tract infections in the Asia-Pacific region: 2009-2010 results from the Study for Monitoring Antimicrobial Resistance Trends (SMART). Int J Antimicrob Agents 2012;40(Suppl):S37–43.
Tansarli GS, Athanasiou S, Falagas ME. Evaluation of antimicrobial susceptibility of Enterobacteriaceae causing urinary tract infections in Africa. Antimicrob Agents Chemother 2013;57(8):3628–39.
Akram M, Shahid M, Khan AU. Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in J N M C Hospital Aligarh, India. Ann Clin Microbiol Antimicrob 2007;6:4.
Haque R, Akter ML, Salam MA. Prevalence and susceptibility of uropathogens: A recent report from a teaching hospital in Bangladesh. BMC Res Notes 2015;8:416.
Sohail M, Khurshid M, Saleem HGM, Javed H, Khan AA. Characteristics and Antibiotic Resistance of Urinary Tract Pathogens Isolated From Punjab, Pakistan. Jundishapur J Microbiol 2015;8(7):e19272.
Rattanaumpawan P, Tolomeo P, Bilker WB, Fishman NO, Lautenbach E. Risk factors for fluoroquinolone resistance in Enterococcus urinary tract infections in hospitalized patients. Epidemiol Infect 2011;139(6):955–61.
Rattanaumpawan P, Tolomeo P, Bilker WB, Fishman NO, Lautenbach E. Risk factors for fluoroquinolone resistance in Gram-negative bacilli causing healthcare-acquired urinary tract infections. J Hosp Infect 2010;76(4):324–7.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.